LIBRARY OF CONGRESS, 



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UNITED STATES OF AMERICA. 



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THE EYE 

IN 

ITS RELATION TO HEALTH 



THE EYE 



ITS RELATION TO HEALTH 



CHALMER PRENTICE, M.D. 




MAY 25 1895 

CHICAGO 
A. C. McCLURG AND COMPANY 

1895 



VEs 



COPYRIGHT 
By A. C. McCLURG AND CO. 

A. D. 1895 



NEW THEORIES THAT ARE TRUE, MEET ALL THEIR 
OPPOSITION FROM THOSE WHO MISUNDERSTAND THEM 



THE EYE 

IN 

ITS RELATION TO HEALTH. 



I. 

A CRITIC is one who is skilled in judging of 
the merits of a work. He must be a con- 
noisseur ; he must be an adept, before he is able 
to pass judgment of high value. 

In this work many ideas are set forth that are 
entirely new. Many tests are suggested that 
may seem strange, and results recorded that 
appear incredible, but the value of these tests can 
not be determined without thorough investiga- 
tion. Viewed from the standpoint of our earlier 
professional teaching and experience, the position 
I assume may seem to be wrong ; yet careful in- 
vestigation as directed in this work will perhaps 
prove that new methods will produce new results. 
Some months or even a year and more ought to 
be spent in the experiments suggested in this 
work, for many of the changes sought are, at the 
best, slow, and the conditions with which we deal 
are at times obstinate and deceptive. 

After investigation, I invite criticism. "Truth 
7 



o THE EYE IN ITS 

is mighty and will prevail." This is the one sus- 
taining thought to one who presents anything 
new to the world; and for appreciative and valu- 
able criticism of this work I turn to those only 
who are possessed of careful, discriminating, 
strong, individual judgment, and whose conclu- 
sions are always based on a thorough investiga- 
tion of facts. 

However extensive the experience of any 
oculist may have been, I do not expect from him 
full concurrence in my opinions as a result of 
that experience ; and any judgment from that 
plane I shall deem in a great measure unfair ; but 
from such a source, after careful consideration of 
the methods I have suggested, I do expect con- 
currence, or, at least, fair criticism. 

A perfect judgment can not be fairly arrived 
at by reading only a part of this work, for ques- 
tions might suggest themselves on one page which 
would be satisfactorily answered by a continuous 
and careful perusal of all the pages. 

A subject like the present, pointing toward 
advancement in the field of medicine, is too 
sacred to be trifled with by casual and inexperi- 
enced criticism ; but all honest inquiry regarding 
my methods I will cheerfully answer, hoping 
thereby to advance medical science. 

I fully realize that many of the following 
statements may seem incredible; but they can all 



RELATION TO HEALTH. 9 

be practically demonstrated by carefully con- 
ducted tests in any suitable clinic, which is the 
only place in which to decide a question of so 
important a nature. Under suitable conditions, 
I shall be pleased to make these tests at any time. 
There seems to be little, if anything, left to 
discover concerning the laws of refraction in their 
application to defective vision. Helmholtz, Don- 
ders, Landolt and many others seem to have 
solved nearly every problem in matters of refrac- 
tion and the application of glasses for correction 
of the same. Many ingenious methods have 
found their way into use for determining, both by 
objective and subjective examinations, the arti- 
ficial aids to produce the most perfect vision. 
The acquisitions in this field are the result of many 
years of careful investigation, through all of which 
the tacit assumption has been, that, when the eye 
was so corrected and the function of vision at 
once more easily and perfectly performed, all that 
could be desired had been accomplished. Here 
is exactly where the greatest error has existed ; 
and it has lain so deeply hidden that it is not en- 
tirely strange that it has remained so long undis- 
covered. What misled us to the greatest extent 
was that, when the function of vision was perfectly 
performed, we rested in the belief that the eye was 
perfect ; but it did not occur to us that some eyes 
might be using an excessive amount of nerve- 



io THE EYE IN ITS 

impulse to bring about and sustain that perfect 
vision. 

Long years of effort are made by defective 
eyes to perform the function of vision as perfectly 
as possible. When necessary, the nerve-centers 
innervate to their utmost power the various eye 
muscles, causing a change of shape in the crys- 
talline lens, stretching muscles which were too 
short and shortening muscles which were too 
long, to enable the eyes to look in the same 
direction. These conditions are continued, and 
more or less sustained, from day to day through a 
period of many years. Thus, anatomical parts 
that were manifestly imperfect at birth meet 
with changes in shape that become more or less 
established, so that it is impossible at once to 
discover and correct the same by fitting such 
glasses as produce the most perfect vision. Such 
a procedure is often incorrect, inasmuch as it 
stimulates the maintainance of abnormal condi- 
tions that, as soon as possible, ought to be dis- 
covered and corrected. When all the facts are 
carefully considered, we can readily see that we 
may have more or less firmly fixed conditions, 
which will only recede gradually and thus permit 
the eye slowly to assume a normal state. 

In a slight measure, the discovery of the ac- 
tion of atropine, hyoscyamine, and similar drugs 
on the eye, has taught us that the first manifest 



RELATION TO HEALTH. ■ n 

conditions that present themselves to us in latent 
hypermetropia are not what they seem. For in- 
stance, a spasm in the ciliary muscle often hides 
a great measure of the defect, making the eye 
appear more perfect than it really is. Similar 
hiding power may exist in any of the other ocular 
muscles and deceive us as to their true conditions. 
It is for this reason that many people experience 
great and repeated trouble in their endeavors to 
have their vision properly corrected. They pass 
on and on from one professional man to another, 
receiving from each a correction that proves but 
temporary ; and yet it is probable that each cor- 
rection was made scientifically and fulfilled all 
needs that the eyes manifested at the time of each 
examination. Every oculist has had his trouble- 
some cases of this kind. 

The reason why greater uniformity of opinion 
has not existed concerning treatment through the 
sight centers, is that our observations have been, 
confined to more or less manifest defects, and 
these at best represent but a very small percent- 
age of the disturbing conditions that may exist in 
the ocular apparatus. Defective eye muscles, 
which tend to cause the eyes to deviate from a 
normal position, were tested by various methods 
tending to destroy the fusion stimulus ; but these 
methods discover only a very small percentage of 
the existing abnormal conditions. The great ma- 



12 THE EYE IN ITS 

jority of disturbing causes are not to be found in 
manifest defects of muscle balance. Some of the 
most serious conditions exist where the muscle 
balance is apparently perfect, the defect being a 
fixed abnormal innervation which is sustaining a 
perfect position of the eyes, and which continues 
to maintain it under all tests that rely on the 
artificial disturbance of fusion power (diffusion 
tests). 

Further than this, in a large share of those 
cases where the deviations are manifest, the eyes 
are turned in exactly the opposite direction to 
that in which anatomically short muscles would 
turn them. For instance, a right eye with a short 
superior muscle, instead of being drawn upward, 
might tend downward to a considerable extent by 
the force of spasm. The nerve-impulse sent to 
the inferior muscle to enable it to hold the eye 
down level with its fellow, becomes, through re- 
sulting irritation, more than is necessary, and pulls 
the eye down beyond a balance ; so that the op- 
posite eye will be the higher of the two under the 
diffusion test, because the abnormal impulse is 
permanent. It can readily be seen that the usual 
correction of an eye manifesting this reverse con- 
dition would prove injurious instead of beneficial. 
I have spoken at length elsewhere on this class 
of cases ; adverse results in them are strong rea- 
sons why we have not attained a more general 



RELATION TO HEALTH. 13 

success. Such results have failed to make the 
treatment impressive, and from the very nature of 
these cases as set forth in this work, it will be seen 
how unreliable any and all of such tests are, 
however complete and perfect their destruction of 
fusion power may be. 

Again, eyes that are capable of prominently 
manifesting their defects are more or less at rest 
when not in constant use, whereas absolutely la- 
tent eye troubles find no such periods of relief. It 
is from the latter and the reverse class that the 
most serious nervous disturbances take their rise. 
The correction of muscular insufficiency or man- 
ifest irregularity must not be confounded with the 
idea of repressing abnormal innervation. One 
is not a modification of the other, nor do they 
bear the slightest resemblance to each other, 
though both methods of treatment are through 
the medium of the eyes ; and it would be as fool- 
ish to confound them with each other for this 
reason as it would be to confound various schools 
of medicine because the remedies are applied 
through the medium of the mouth. 

Eye-strain, or excessive abnormal innervation 
of the eye muscles, depletes the nerve-centers. 
It also gives rise to brain irritation of varying 
degrees. Dispositions are altered by it ; char- 
acter is forcibly changed ; mental faculties are 
impelled into channels of work that are anoma- 



14 THE EYE IN ITS 

lous. Into such an altered state these conditions 
may force a being as to make him appear to the 
world an entirely different character from what 
he otherwise would have been. So, if in time 
these disturbing conditions can be corrected, we 
may expect to see favorable changes in the 
physical, mental and moral parts of the indi- 
vidual. 

Some very remarkable cures have followed 
the correction of defects in and about the eyes ; 
in fact, so wonderful have some of these changes 
been, that to the novice it seemed absolutely in- 
credible that anything in connection with the eye 
could have been the real cause of the change; and, 
naturally, he turned in some other direction to 
account for the facts which were too stubborn to 
be denied. Generally what is called "mental- 
suggestion," in some of its forms, has been settled 
upon as the cause of these changes. Some per- 
sons have more or less belief in the efficacy of 
suggestion, or they would not turn to it as such a 
potent cause ; but suggestion as a curative power 
has been known under various names for ages. 
Gasner, a priest of Bavaria, was said to have 
worked some remarkable cures by laying on of 
hands. Hell, of Austria, claimed a wonderful 
healing potency in the magnet. Mesmer took 
his cue from the preceding claimant, and evolved 
what has been known for a century as mesmer- 



RELATION TO HEALTH. 15 

ism. About the close of the last century, the 
French Academy appointed a commission to in- 
vestigate the principles involved in Mesmer's 
work. Benjamin Franklin was a member of that 
commission. The decision arrived at was, that 
whatever effects were produced were of a tempor- 
ary character, and due entirely to suggestion. 
Hypnotism and braidism are simply other names 
for practically the same influence. There are 
other methods of more modern birth that owe 
whatever efficacy they possess to suggestion. I 
think all careful observers are ready to admit 
that there is considerable influence in suggestion, 
both for good and for evil, especially on weak, 
nervous people. The evil effect will prove the 
greater and more lasting of the two. 

However potent suggestion may be, it has 
never been an aid to curative results through the 
medium of the eye ; on the contrary, it has been 
the most detrimental element in the way of its 
advancement. Suggestion is more effective in 
the shape of ridicule than any other form of its 
administration, for it is easier to depress than to 
elevate a failing life ; and such we have frequently 
seen sacrificed to the potent evil influence of sug- 
gestion. The strongest evidence of the true value 
of treatment through the eye is the fact that 
it has made all of its advancement through a 
storm of opposition and ridicule, the only argu- 



i6 THE EYE IN ITS 

ments of the unenlightened. Suggestion cannot be 
said to have had any influence in lunacy and other 
states of lost minds that have been influenced and 
restored by eye treatment. Prisms in a certain 
position often relieve pain, and when reversed in- 
crease it ; yet the suggestion is equally potent in 
either position. 

It is common and natural to cling to a belief 
in things and methods that have long been estab- 
lished, and in which leading men and authors 
concur; and, if the results of such following are 
universally perfect, more cannot be desired. But, 
when they fall far short of satisfaction, we are 
warranted and even impelled to search outside of 
established authority for the aid that it fails to 
give ; otherwise, science and art would never 
advance. 



RELATION TO HEALTH. 17 



II. 



NO part of the living body is constructed in 
vain. Every minute portion has some par- 
ticular office to perform. However simple or how- 
ever complex any one of these parts may be, it is 
so constructed as to facilitate the work that it has 
to do. Each distinct part may be looked upon as a 
little engine which is put in motion by the appli- 
cation of the motive-force that enables it to per- 
form its function. This motive-force is conveyed 
from the place where it is generated, through 
conductors called nerves, to the part where the 
function is performed; and, like the running of an 
ordinary engine, the character of the function is 
determined by the character of the motive-force 
supply. If the proper amount of steam is admit- 
ted to perform the function of the engine, the 
work is properly and evenly done. If too much 
steam is turned on, the engine runs too rapidly 
and is likely to do itself injury by over- work. If 
too little is applied, the running of the engine is 
very feeble and can be stopped by the slightest 
interference. If the steam is cut off entirely, the 
engine stops. Here we have a perfect analogy 
to all functions in the human or animal body. If 



1 8 THE EYE IN ITS 

the motive-force is just adequate to the necessi- 
ties of the part, the function will be normal ; but, 
if the motive-force is in excess, the function will 
be erratic and unnatural, exhibiting disturbances 
which will be classified as some disease of the 
part, which will be of an active nature. If the 
motive-force is lacking in quantity and regularity, 
the result will be that the function will be very 
feebly performed, and some sluggish, indolent 
condition will follow, which will be classified as 
an inactive, indolent disease. These changes, 
which are similar in all parts, can be easily noted 
and demonstrated in the action of the heart. In 
a state of perfect health, the nerve-centers are 
furnishing and sending to this little engine, 
impulses of motive-force which give rise to a reg- 
ular, unvarying beat of about seventy impulses to 
the minute. Now, if the nerve-centers be excited 
in any way, the heart's action at once will mani- 
fest the change. A cry of fire, a terrific explosion, 
or the sudden consciousness of some important 
news of good or bad import, causes an excitement 
of the nerve-centers in which the supply of nerve- 
force is temporarily increased, and a larger amount 
than usual traverses the various nerves throughout 
the entire system. The heart's action becomes 
violent and rapid, manifesting the exact amount 
of change of motive-supply from the nerve-centers 
to the heart. We note the changes of action par- 



RELATION TO HEALTH. 19 

ticularly in the heart, whereas the fact is, every 
function in the whole body is equally affected, 
but the change is not so manifest to our ob- 
servation ; nevertheless, the alteration of function 
everywhere in the body is equivalent to the 
change in the motive-force supply. The nature 
of the function, whether it be normal or erratic, 
is a manifestation of the character of the motive- 
force supply, really giving us a perfect idea of the 
condition of the nerve-centers from which the 
force is proceeding. This would naturally lead us 
to the conclusion that all alterations of func- 
tion ARE PRIMARILY CENTRAL IN THE NERVOUS 
SYSTEM. 

Every organ in the body has special organic 
work to perform. Likewise, the various tissues 
of which the organ is constructed have functions 
to perform. Every little living cell, be it bone, 
nerve, muscle or any tissue, has a function to per- 
form called assimilation. A cell of adipose or 
fat possesses the power to attract to itself carbon, 
hydrogen, and oxygen, or matter of its own kind, 
in just the proportions of which the cell is com- 
posed, and in quantity just sufficient to maintain 
the proper size of the cell : surrounding the cell 
is the cell wall structure, which is doing a separate 
work by drawing to itself matter of its own kind, 
but in different proportions to the cell within : 
again, adjacent to this is a cell of muscle, bone, 



20 THE EYE IN ITS 

periosteum or other structure, each attracting dif- 
ferently unto itself elements of its own kind, in 
just the proportions that each needs : and so on 
throughout all the various structures of the animal 
economy. These are all separate little functions. 

The blood is simply a carrier of the food 
from which all the elements of the body derive 
their sustenance ; but it does not perform the 
multiple function to select, for the many cells of 
various kinds, their individual complex require- 
ments. Each individual cell possesses the power 
to select by its polar forces that which it requires; 
and these forces are generated and sustained by 
nerve-impulse. 

Each separate and individual part or organ of 
the animal economy has some special place or 
center in the nervous system that presides over it; 
some specific center where is generated the 
motive-force that performs the function of the 
part over which it has control ; and the manner in 
which the part does its work determines for us 
the condition of its motive center. A very few 
of these nerve-centers have been located ; yet a 
sufficient number to assure us that each function 
has, somewhere in the nerve-centers, a special 
place that is generating and sending forth that 
force which does the work. 

We may look upon the brain as a series of 
dynamos that are constantly generating motive- 



RELATION TO HEALTH. 



force, and sending it out over the various con- 
ductors that we call nerves, which convey it to 
the place where the work is done. This force 
polarizes the cell structure, which then performs the 
work of attraction and repulsion. 




i. Visual centers. 5. Complicated movements of hand, 

2. Taste, smell and sexual feeling arm and leg. 

(centrally located). 6. Coarse leg movements. 

3. Hearing. 7. Coarse arm and leg movements. 

4. Face, tongue and speech. 8. Coarse arm movements. 

9. Writing images. 

When the liver, kidneys, heart and other 
organs continue to perform their various offices in 
a healthy manner, the inference is that the motive- 
forces are being furnished accordingly ; but, 
whenever any of these organs begin to perform 
unnatural offices — generating abnormal secretions 
such as sugar, uric acid, etc. — we infer that abnor- 
mal motive impulses have supervened. 

Normal secretions are the outcome of nor- 
mal FUNCTIONS PERFORMED BY NORMAL IMPULSES. 

Abnormal secretions are the outcome of 



22 THE EYE IN ITS 

ABNORMAL FUNCTIONS PERFORMED BY ABNORMAL 
IMPULSES. 

Each class of secretions is dependent on its 
characteristic motive-force. In other words, 
when a function becomes abnormal, it is not the 
part or engine that is at fault, it is always the 
motive-impulse which is responsible for the 
erratic work. For, even if the part itself through 
local irritation or injury, is caused to change its 
action, it even then does it by first sending the 
irritation to the presiding nerve-center, which 
reflects the impulse that causes the change. 

When a bone is broken, the first natural, local 
changes that follow are pain and inflammation, 
which occur as follows : From the point of irri- 
tation caused by the fracture, an impulse is sent 
to the nerve-centers that preside over the part. 
They return their characteristic impulses to the 
place of injury, which at once establishes an 
inflammatory action at the place of rupture ; and 
this action involves the manufacture or formation 
of those products or elements needed to repair or 
heal the part. These are new, temporary func- 
tions. Without this communication from the 
injury to the nerve-centers and the corresponding 
return current, the fractured ends would never 
become reunited nor the injury repaired. 

I have in mind a case of a railroad employe 
who was under my care some twenty-five years 



RELATION TO HEALTH. 23 

ago. Both bones in the lower part of the leg 
were broken and protruded through the skin. The 
fractured ends were properly adjusted. In a gen- 
eral way, he was an unhealthy man, with a very 
weak nervous system. After several days, the 
patient remarked to me, "I think you are a very 
good doctor for I have no pain in my leg." I 
said, "My dear fellow, that is just what does not 
suit me. I prefer that you should have some 
pain and inflammation." But it did not follow. 
For one hundred and forty days, I tried all the 
various methods known to get up an irritation in 
the part, after which I first discovered symptoms 
of the broken ends reuniting themselves. In this 
case, the delay resulted from the weak condition 
of the nerve-centers and their inability to respond 
by sending back to the injured part the proper 
nerve-impulse to establish the inflammatory ac- 
tion of repair. Never can work or function be 
performed without the appropriate application of 
some motive-force to perform it. 

However brilliant an inventive genius may be 
in all other directions, he begins to lose his reason 
when he searches after perpetual motion, or a 
piece of machinery so constructed as to possess 
in itself the power to do the work or perform the 
function. Such an unfortunate genius generally 
ends his life in a lunatic asylum. As in mechanics, 
so in animal life, all effects have a cause. 



24 THE EYE IN ITS 



III. 



SIGHT is not passive, it is an active function ; 
and, although we see apparently without 
effort and without volition, yet every moment of 
vision is costing its adequate amount of vital 
energy. True, we cannot say just how much 
energy is utilized in looking any given length of 
rime at any particular scene ; but we do know that 
many nervous persons are very much exhausted by 
the use of the eyes for a short time in an art gal- 
lery, where things of great interest are constantly 
attracting their attention. Some are more ex- 
hausted by one hour of such effort with the eyes 
than they would be by ten hours of manual labor; 
consequently the same amount of vital force that 
would be required for ten hours of labor, may be 
disposed of in one hour through the medium of 
the eyes. Now, if there be some defect in the 
construction of the eyes, the consumption of 
nerve-force will be much greater ; for example, a 
short superior muscle in one eye requires many 
times the amount of nerve-force to perform 
the function that the centers were ever intended 
to furnish. The function of sight may be as suc- 
cessfully performed as if the eyes were perfect, 



RELATION TO HEALTH. 25 

but only by an excessive call on the nerve-cen- 
ters to maintain a balance between the two eyes ; 
in such cases the vision is sometimes of more 
than average sharpness. This extravagant waste 
might find a good parallel in the following : An 
electric plant is scientifically constructed for the 
purpose of running fifty arc lights ; each light 
utilizes a given amount of electric force that is 
generated at the electric center, and the fifty 
lights just use up what force the dynamo can 
easily generate. Now, in the place of one 
of these arc lights, if we place an electric motor 
which uses twenty times as much force as the 
light that it has displaced, the whole electric sys- 
tem will be disturbed, from the fact that the elec- 
tric motor is utilizing more than its share of the 
motive-force ; consequently the other forty-nine 
lights in the circuit will not receive enough to 
perform their intended functions ; they will sput- 
ter, burn irregularly and feebly. We have here 
a state of affairs in our arc light system which 
may be likened to that form of nervous debility 
where the prominent feature is constant exhaus- 
tion, due to a lack of sufficient force of nerve- 
impulse. But in the animal economy, another 
condition may follow when the "dynamo" is 
over-taxed ; the nerve-centers may be excited to 
an irritable condition in which they generate an 
excessive amount of nerve-force, and then we 



26 THE EYE IN ITS 

have an excited or agitated form of nervous 
derangement ; and, whether it be general or local- 
ized, it soon wears out life. 

Strictly construed the terms neurasthenia and 
nervous debility mean a weak or depressed 
nerve-force supply. They are sometimes care- 
lessly applied (but are not properly applicable) 
to all nervous derangements ; for we often meet 
with nervous derangements that consist of an 
excessive supply of nerve-force, usually accompa- 
nied with more or less irritability, all functions in 
general being emphasized. The enormous assim- 
ilation in abnormally fat persons, and the exces- 
sive muscular development and activity in a class 
of phenomenal athletes, whose histories are short 
and generally end in some rapidly wasting dis- 
ease, are extreme examples of that form of ner- 
vous derangement which consists of an excess of 
nerve-force supply and which should be called 
nenrosthenia. The term abnormal -innervation 
embraces both of these conditions. 

Our fast ocean steamers can run nineteen or 
twenty miles an hour without excessive con- 
sumption of fuel ; but when the speed is raised 
to its highest possibilities, the last two, three or 
four miles are attained at a very extravagant 
increase in the fuel, the consumption being far 
greater in proportion per mile as well as resulting 
in a great strain throughout the ship. A ship is 



RELATION TO HEALTH. 27 

sometimes unable to sustain the highest tension 
that can be put upon her by her engines, in 
which case the good engineer turns off the excess 
or abnormal quantity of steam, slows her speed 
to an easy pace, and thus her life in the waters 
is lengthened many years. Likewise when we 
learn that some of our functions are being per- 
formed at an abnormally high tension requiring 
an extravagant amount of nerve-force to sustain 
them, which is rapidly wearing us out, we should 
suspend this high rate of function and conserve 
as far as possible our life forces, by removing the 
cause of the irritation and waste. 

The nerve-centers are capable of generating a 
certain amount of motive-force or nerve-impulse 
and no more. Whenever the call upon the cen- 
ters exceeds their ability to respond, the result is 
a disturbance somewhere. A large amount of 
motive-force is utilized in the function of vision 
even when it is performed under the easiest 
possible circumstances ; but when there are de- 
fects in the eye and its appendages, there is a 
still greater demand for nerve-force to bring 
about good vision. 

Each nerve-center is intimately connected and 
in delicate sympathy, with all other centers of 
the nervous system. Any radical change in one 
center sends its characteristic influence through- 
out all. 



28 THE EYE IN ITS 

Harmonious and pleasant sounds, picturesque 
scenes filled with things of beauty, loveliness 
and goodness, have the most marked influence 
over the nerve-centers in general and manifest 
themselves in the form of the body, the grace of 
movement and the sweetness of expression in 
the features. Such external influences have a 
tendency to produce, through the medium of 
vision, the perfect man and woman ; whereas the 
one who is reared amid scenes of crime and bru- 
tality, coarseness and privation, is so influenced 
in his whole physical being that, to the experi- 
enced eye, their marks are everywhere to be seen. 

The reason husband and wife grow to look 
alike after living years in each other's company 
is, that they have looked so constantly upon each 
other's features, have been made glad by the 
same influences, have enjoyed the same sunshine, 
have met with the same sorrows and have been 
so often subjected to the same experiences, that 
their functions have become similar. 

Now what particular portion of the nerve- 
centers should we expect to have the greatest 
influence in changing and controlling the general 
nervous system? Would it be one of the duller 
centers, or would it be the most acute and sensi- 
tive? We would reasonably look to the most 
sensitive as bearing the highest influence both for 
good and evil. 



RELATION TO HEALTH. 29 

Of all the centers in the nervous system, 
which is the most sensitive, the most highly acute 
and the most constantly in use? 

The answer is, that center in which the most 
positive impression is made by the lightest and 
most delicate touch or impact. Various parts of 
the body, for instance, the fingers, come in con- 
tact with a substance ; immediately there is an 
afferent impulse communicated to the nerve-cen- 
ters that says, 'this is velvet, fur, wood, metal, 
hot or cold.' Again, substances of different 
flavors are taken into the mouth. When they 
come in contact with the nerves of taste (gusta- 
tory nerves) the afferent impulses from this con- 
tact convey to the nerve-centers the consciousness 
of the presence of lemon, orange, vanilla, etc., 
and the reflex of swallowing or deglutition fol- 
lows. If the flavor be something which conveys 
to the nerve-centers a disagreeable or nauseous 
taste, the opposite reflex follows, and an effort is 
made to reject the offensive material instead of 
swallowing it. 

The auditory center discriminates in all the 
delicate sounds known to music, in all the varieties 
of harmony and discord. The potent influence 
of music on the feelings of man and beast is well 
known. 

Another sense equally or more delicate, is that 
of smell. The perfumes emanating from helio- 



30 THE EYE IN ITS 

trope, violet and other flowers can neither be 
weighed, measured nor analyzed, being so deli- 
cate and imponderable ; yet, the sense of smell 
produced by them is of a very positive nature. 

As delicate as the above named senses are, 
there is yet another of a much more highly acute 
nature ; in fact, by far the most delicate sense of 
all, sight. 

Light is imponderable ; its rays, reflected 
from various objects, pass through the cornea, 
the aqueous humor, the crystalline lens, the vit- 
reous body, and there reach the retinal nerves. 
The delicacy of this touch or impact on the 
retinal nerves is beyond the conception of the 
human mind ; yet it establishes from this point 
an impulse which is conveyed to the visual or 
sight centers of the brain, which with no uncer- 
tainty, determines form, color, motion, quantity, 
and space. Here we have the most positive 
sense or feeling known to man ; sight, produced 
by an impact or touch of the most imponderable 
agent or force known to science. There is not 
an impression, feeling or sense with which the 
nerve-centers have ever been made familiar which 
is not in some measure reawakened through the 
visual apparatus. 

The musician runs his eye over the page of 
written music, and he hears it. One sees a person 
across the street eating a lemon, and he tastes it. 



RELATION TO HEALTH. 3 1 

The salivary glands begin to act ten rods away 
from the lemon. We see a person's foot run 
over or crushed, and we feel the wound. It 
produces changes throughout the observer's 
nervous system, nausea results, and often so 
forcible is the effect that unconsciousness follows. 
Through this medium, mothers have communi- 
cated deformities to their offspring by changes in 
the nerve-impulses that control the function of 
construction or building. There are many sub- 
stances which we cannot recognize by the sense 
of touch, but which sight determines for us at 
once, showing that the visual nerve-centers are 
the most sensitive of all. 

It is through the feelings awakened by sight 
that in reading a book and looking at its illustra- 
tions, we are enabled to live in the very atmos- 
phere of the scene that is depicted and to drink 
and satiate ourselves to the fullest extent, feeling, 
tasting, smelling and hearing the various things 
and surroundings that the author suggests. 

If the light of a single candle is sufficient to 
produce a perfect impression of a given object in 
the visual centers, say a letter A, there is a feeling 
produced in the nerve-centers that tells us of the 
presence of a letter A. If twice the light that is 
necessary is reflected from this letter A, twice the 
impact or impression that is necessary is conveyed 
to the visual centers and they are taxed to a 



3 2 THE EYE IN ITS 

double capacity. Should this light be increased 
to twenty candle power, where one would be 
sufficient, the visual centers will receive an 
impulse twenty times as strong as necessary to 
produce the function of seeing the letter A, or 
whatever object the eye may be resting upon, and 
the feeling of sight is over-taxed and disturbed ; 
for sight is nothing more or less than feeling. 
This excessive amount of useless work even in a 
normal eye wears on these delicate centers 
beyond necessity, and they become centers of 
irritation and convey disturbed conditions to 
other parts or centers of the nervous system. I 
touch a person on the shoulder gently ; this per- 
forms the function of attracting his attention. 
Again, if I were to use a club and strike a severe 
blow, the attention would be attracted, but the 
force of the impact would be more than necessary 
and an injury to the part would be the result. 
It is the same with the delicate sight centers. 
Just a sufficient amount of light to perform the 
function is all that is required, but a flood of 
enough force can be admitted to practically 
bruise these delicate parts of the nervous system. 
Since the advent of electric lights which have 
practically turned night into day, there has been 
an increase in nervous disturbances, due to over- 
taxation of the visual centers of the nervous 
system. We turn our eyes in the direction 



RELATION TO HEALTH. 33 

of hills, valleys, rivers and woods, and the 
light reflected from the various objects 
passes into the eye and touches the nerves of 
sight. From here an impulse is conveyed to the 
sight centers of the brain and here we feel the 
form, size, color and motion of the various 
objects in the scene. 

The feeling of harmonious sounds in the audi- 
tory centers is enjoyable for the space of two or 
three hours, but a continuance beyond this length 
of time becomes tiresome, and the same sounds 
repeated for five or six hours would be annoying. 
These centers become temporarily exhausted or 
worn out. 

The feeling of taste when eating the choicest 
delicacies, in a short time, perhaps an hour, 
becomes wearied, temporarily perverted, and 
beyond this time enjoyment ceases. The gusta- 
tory centers refuse to be further taxed. 

The feeling of smell through the olfactory 
centers is very delightful for the first few inhala- 
tions of some delicate perfume ; the sense of 
smell is at first prominent, but after a few 
moments the odor seems to excite no feeling at 
all. Nothing but the pungent feeling of alcohol 
at last is present. From over-work the olfactory 
centers have suspended their functions. 

The feeling in the visual centers commences 
at seven o'clock in the morning and continues 
3 



34 THE EYE IN ITS 

until ten o'clock at night. For fifteen hours con- 
tinuously, more or less, the feeling in the visual 
centers has been constant. No other sense in the 
nerve-centers is capable of such continued endur- 
ance. 

For good or for evil, according to their char- 
acter, the senses of feeling, taste, smell, hearing 
and sight have all a marked influence both on our 
mental and physical lives. Sounds of harmony, 
delicacies of wholesome and pleasant taste, odors 
that delight and please the sense of smell, and 
scenes of beauty, all have an elevating influence 
over our mental and physical lives tending to a 
refinement of both mind and body ; while the 
opposites of these experiences produce an un- 
favorable or opposite effect throughout. 

"Why was the Grecian a poet and philosopher, 
while the Scythian was a wanderer and robber ? 
One was reared amid surroundings of beauty and 
culture, the other had a barbarian land, rude as 
his manners and wild as his heart. 

Again I repeat, The visual centers are the 

MOST SENSITIVE AND MOST CONSTANTLY TAXED, BE- 
CAUSE THE MOST CONTINUOUS AND POSITIVE FEELING 
IS PRODUCED BY THE IMPACT OF AN IMPONDER- 
ABLE agent. The touch of only a subdued ray 
of light gives rise to a feeling which is the 
most certain and continuous of all functions of 
feeling. 



RELATION TO HEALTH. 35 

As to the anatomical location of the nerve- 
centers generally, it will have to be a matter of 
speculation, because an immense amount of re- 
search prosecuted by able men has located only 
a few of them. Victor Horsley in his work 
on "The Brain and Spinal Cord " says: "Per- 
sonally, I believe that anatomical research will 
do less than physiology toward settling these im- 
portant and most difficult questions, and that as a 
fact, we shall not advance very far towards their 
solution until we are able to approach them from 
the standpoint of their functions, which of course 
is a totally different mode of comparative invest- 
igation." Also, "Anatomy is not able to adduce 
absolute evidence either as to agreement or disa- 
greement in the evolution of the structure, it is 
likely that the physiological aspect of the case is 
the more correct one." 

From a physiological standpoint, there would 
appear to be a great number of visual centers in 
the nervous system. When rays of light are re- 
flected from an object and focussed in each 
eye, there is a strong effort of the two eyes to fix 
themselves in such a position that the picture 
made or reflected on the posterior part of each 
eye shall be in corresponding localities. A ray 
of light falling exactly on the most sensitive cen- 
ter or yellow spot of the right eye, stimulates 
through the nerve-centers, a tendency to fix the 



36 THE EYE IN ITS 

left eye in such a position that a ray of light 
emanating from the same point will also fall upon 
the most sensitive center or yellow spot in that 
eye. The same tendency prevails throughout 
the field of vision. If an eye is fixed on an ob- 
ject, it will be possible to see other objects for 
quite a distance in various directions without 
moving the eye ; for instance, objects upward as 
far as 45 deg. can be seen, outward over 90 deg., 
downward about 70 deg., inward 55 deg. to 60 
deg., according to the prominence of the bridge 
of the nose. To define an object as having form, 
it is necessary that several impressions be re- 
ceived in the nerve-centers simultaneously or 
nearly so. The average acuity of vision is said 
to be an angle of one minute. The top of a letter 
E falls on a portion of the retina that conveys an 
impression of its existence, also the tongue of 
the letter and the bottom of it ; the upright 
portion and the two spaces between the tongue 
and the upper and lower parts, fall upon 
separate portions of the retina, each of which 
takes a distinct impression, and their relative 
positions are noted by separate and distinct 
sensory centers in the brain ; consequently we 
feel the form of the letter E. If it were a single 
sensory center that these distinct and separate 
objects were conveyed to, it would be a single 
confused impression. So, from a physiological 



RELATION TO HEALTH. 37 

standpoint, we see that each minute point in the 
posterior part of the eye or field of vision is sus- 
ceptible of taking a separate impression, and has 
somewhere a distinct sensory center in the nerv- 
ous system. In looking directly in front of me, 
I see a red light off to the right, because rays 
emanating from it have fallen on that portion of 
the field of vision that conveys its impression to 
that particular center in the brain that locates it, 
and always does locate any object falling upon it, 
to the right of the optic axes ; and so it is with 
each minute and separate locality throughout the 
entire field of vision. When we contemplate the 
numerous objects that may be distinguished with- 
out moving the eye, we may conceive how numer- 
ous must be the sensory centers for the function 
of vision. At least one for each angle of vision. 
When the two eyes are fixed so that rays of 
light falling from a given point are reflected on 
corresponding localities in the field of vision, a 
single impression of the object ensues, because 
each of these corresponding points is supplied 
with a nerve-filament that leads to a common or 
single sensory center ; but when rays coming 
from the same point fall on different or non-cor- 
responding localities in the two eyes, they neces- 
sarily meet with nerve filaments originating from 
two different sensory centers, and each eye con- 
veys an impression of the same object to dis- 



3§ THE EYE IN ITS 

tinctly separate centers, and two impressions of 
the same object are the result. Always, under 
such conditions, there is a strong effort of the 
two eyes to fix their optic axes parallel so that 
the two apparent objects may be fused into one, 
thus avoiding confusion, and increasing the 
sense of vision. In doing so, the various mus- 
cles act as follows : Let two imaginary lines 
bisect each other at right angles, one horizon- 
tally and the other vertically, and we shall 
have a cross. Now, suppose the eyes to be out 
of visual line so that a dot will appear to the 
right eye to be in the lower right hand corner 
of the space occupied by the cross, and that to 
the left eye the same object will appear in the 
left upper portion of the cross. These impressions 
simultaneously seen with both eyes will appear 
as two dots. To merge or fuse these two im- 
pressions of the dot into one, the external and 
internal muscles move the eyes laterally until 
they are in such a position that the two dots are 
brought to the imaginary vertical line of the 
cross. One will now be above the other. This 
we call the tendency to verticalize exerted by 
the internal and external rectus muscles ; while 
at the same time, the superior and inferior rectus 
muscles move the eyes upward and downward to 
such a position that the dots are brought to the 
imaginary horizontal line. This we call the ten- 



RELATION TO HEALTH. 39 

dency to horizontalize. The vertical and lat- 
eral muscles in accomplishing the above move- 
ments, receive some aid from other muscles. 
This is explained at length elsewhere. These 
tendencies to horizontalize and verticalize be- 
ing exerted simultaneously, bring two impres- 
sions of a dot to the center of the cross, 
merging them into one object. In this posi- 
tion, rays emanating from a single point 
fall on corresponding localities in each eye, 
and are conveyed to a single visual center 
producing the impression of one. The su- 
perior and inferior oblique muscles also play 
their part in the rotations of the eyes, so that 
rays from a single point may fall upon corre- 
sponding localities. The above process is called 

FUSION. 



40 THE EYE IN ITS 



IV. 



WE give specific names to disturbances in 
the various parts or organs of the body, 
but still they are nothing more than erratic func- 
tions, which may be localized in the liver, kid- 
neys, heart, digestive apparatus, lungs or any 
other part or parts of the animal economy. 

Health is that condition in which all the func- 
tions throughout are normal in their action. 
Any departure of a function or functions toward 
an unnatural or abnormal condition is disease. 
Disease is the negative of ease and means some- 
thing uncomfortable or uneasy ; but any change 
of function toward an abnormal condition should 
be classified as a disease, whether it manifests 
itself by discomfort or otherwise. 

Health is normal or hygienic physiolog- 
ical FUNCTION. 

Disease is localized abnormal innervation 
and always central in the nervous system, 
being a lack or excess of motive-force. 

Disease may take its origin from a suffi- 
cient irritation of any of the nerve -centers, 
but much oftener will disease find its origin 
through the most highly acute and sensitive 
centers. 



RELATION TO HEALTH. 41 

What is termed organic disease really consists 
of some lesion of the parts which is the result of 
continued imperfect or erratic function, and in 
the true sense lesion is not disease but the result 
of disease. 

The growth of tumors is due to abnormal in- 
nervation. In a benign tumor there is an excess 
of assimilative nerve-impulse which causes the 
part to gather unto itself more than its propor- 
tionate quantity. In a malignant tumor the 
same condition exists, with the addition that the 
assimilation consists of gathering to itself hete- 
rogeneous elements forming a structure which is 
alien to the part. 

In the study of disease, we have exhausted 
our fullest resources in searching for causes. We 
find various lesions, such as deposit, disintegra- 
tion, hypertrophy, atrophy and heterogenetic 
conditions, and often have settled upon some of 
these lesions as being the cause of other accom- 
panying pathological symptoms. This is not 
true, they are nothing more than accompanying 
conditions or results of disease. A lesion is 

ALWAYS A RESULT AND NOT A CAUSE. It may be 

the source of a still further reflex disturbance, 
but back of all of these conditions is abnormal 
innervation ; and from whatever source it takes 
its origin, it is the first great disturbing cause, in 
all deranged functions. 



4 2 THE EYE IN ITS 

The electric current or impulse passes through 
the cable, under the ocean, conveying intelligence 
from one continent to another. It moves pon- 
derous machinery of various kinds, it traverses 
the trolley and moves the heavy car loaded with 
passengers. Although unseen, we have learned 
to look upon it as a mighty force, as something 
that exists, from the fact of the powerful functions 
that result from its application. In like manner 
we must learn to look upon motive-force or 
motive-current in the animal body as the first and 
most important thing in its very existence, for all 
things that are done are accomplished through its 
agency and nothing is accomplished without it. 

The intent of this work is to treat of nerve-im- 
pulse, its equilibrium or balance in health, and its 
lack of balance or irregularity in disease. In 
speaking of eye-strain, I always mean lack of bal- 
ance in the nerve-impulses of the eyes, and this 
often exists to a high degree when the muscle 
balance is apparently perfect. 

The defects in the eye muscles may be entirely 
latent to diffusion tests. I know it is customary 
when finding small amounts of manifest irregular- 
ities in some of the eye muscles to suspect the 
existence of a still further defect in the same 
direction, a small portion of which may slowly 
manifest itself during a long course of treatment ; 
but further than this latent defects have not been 



RELATION TO HEALTH. 43 

suspected or looked for. The most obstinate cases 
of localized and general nervous debility are more 
frequently the result of conditions which are abso- 
lutely latent, with no manifest deviation to lead 
us to suspect their presence. The only thing that 
leads us to believe that latent eye-strain exists is 
the nervous derangement of the patient. 

Diseases of the eye, like those of the body, are 
localized abnormal innervation. By examining a 
few individual cases, we can draw general conclu- 
sions which will enable us to individualize any 
disease of the eye under the theory of erratic 
function caused by abnormal innervation. Abnor- 
mal innervation of the ocular apparatus causes 
disturbances of the nerve-centers and they are 
reflexed to the eye, disturbing its nutrition or the 
impulses that perform its various delicate func- 
tions. In cataract, from some disturbing cause, 
there is a gradual cessation of those vital forces 
that keep up the nutrition, assimilation and life of 
the crystalline lens, and it ultimately dies, 
becomes a foreign, opaque body. In that dreaded 
and generally incurable disease of the eye, glau- 
coma, one of the most popular treatments is 
iridectomy, also division of the ciliary muscle, 
called cyclotomy. Occasionally these operations 
have been known to arrest the disease, which, in 
my opinion, they do only when the glaucoma has 
been dependent on latent hyperopia or strain in 



44 THE EYE IN ITS 

the ciliary muscle. The iridectomy as well as the 
division of the ciliary muscle would have a ten- 
dency to suspend the tonic spasm or contraction 
of latent hyperopia, and thus in a measure restore 
equilibrium in the distribution of nerve-force 
to various parts of the eye ; but, where these 
operations fail to produce any effect whatever, 
my opinion is that there may be an excessive 
strain in some one of the long muscles that is giv- 
ing rise to the disturbance; and if this is carefully 
sought out and operative measures resorted to, 
the improvement will be as certain as in those 
cases that are relieved by operations affecting the 
ciliary muscle. 

Various forms of inflammation of the eyes are 
due to disturbances in the nerve-impulses, and a 
correction of latent eye-strain, in whatever direc- 
tion it may be found, often acts like magic in 
relieving these troubles after they have resisted 
other treatment. If the examination is careful 
and the operation thorough, rarely will the oculist 
be disappointed in obtaining good results. Any 
disease of the eye, other than zymotic or trau- 
matic, and a continuance of even these may depend 
on eye-strain. 

The microbe theory as to the origin of disease 
is in no way affected by assuming that general 
nervous derangement, in some cases more or less 
localized, is the underlying or predisposing cause 



RELATION TO HEALTH. 45 

of disease in general. If all the organs and parts 
of the animal economy are receiving a generous 
and adequate supply of motive-force from the 
nerve-centers, the functions are necessarily per- 
formed with vigor, and the presence of microbes 
of any character does not prove sufficient to dis- 
turb these vigorous functions. They are continued 
undisturbed by the presence of the microbe, 
apparently much the same as an engine furnished 
with a full and vigorous supply of steam would 
not be perceptibly or materially affected in its 
movements though a hand were to be placed upon 
the fly wheel. It is when the various organs and 
parts of the body are furnished with a minimum 
motive-force from disturbed nerve-centers, just 
barely enough force to keep up the function, that 
the presence of the microbes is sufficient to inter- 
fere with the performance of its work. In this 
case the microbes give rise to the disturbance of 
certain functions, or to their characteristic disease. 
The engine in this case is supplied with so little 
steam that the placing of a hand upon the fly 
wheel proves sufficient to disturb its normal action. 
Thus, in a very plain and simple way, are we 
enabled to account for the immunity of some per- 
sons from disease though they have been exposed 
to infection. Many theories have been adduced 
to explain this, but it is undoubtedly correctly 
explained by this theory. 



46 THE EYE IN ITS 

If twenty people were to migrate into a 
malarious district, some of them would in time 
succumb to the poisonous influences of the 
malaria, which would induce fever and ague, 
bilious, dengue, or some other form of fever 
according to the nature of the microbe. Some 
ten would be constant victims of the malaria, 
while ten of the same company, who breathed the 
same air and drank the same water, would enjoy 
perfect health. All take in the poisonous 
influences in equal proportions ; but those of a 
neurasthenic predisposition will yield to the 
baneful influence, while those whose functions 
are perfect and vigorous will be able to live for 
years without showing that they are in any way 
materially influenced. It is not, as I have often 
heard it expressed, that those who do not suffer 
throw off the microbe ; they take it into their 
systems in the same proportions as those who 
yield to disease, but their functions are so per- 
fectly and strongly performed, that the presence 
of the microbe fails to disturb their action. 

Viewing all disease as localized nervous 
derangement, it will not be necessary to enumer- 
ate the whole category of ills, but a few promi- 
nent ones will suffice, and the same general 
reasoning can then be applied to all the rest, for 
disease is not a thing, an entity. We have 
various erratic, abnormal actions in certain func- 



RELATION TO HEALTH. 47 

tions of the body, and we give them names. For 
instance; if a patient has excessive thirst, and the 
kidneys are secreting a great amount of water, 
the liver has taken upon itself through erratic 
action to manufacture larger amounts of sugar 
than are to be met with in a state of health ; we 
name these functional derangements diabetes 
mellitus. A large train of other symptoms which 
vary greatly in different cases will be noted in 
various forms of this disease, from the fact that 
the irritation in the central nervous system is so 
varied in its character that it sends out corre- 
sponding impulses which perform erratic work in 
various parts of the body. Whatever the nature 
of the erratic function that falls to the liver, 
spleen, or kidneys, it is entirely due to the 
character of its nerve-impulses. In diabetes, 
it is safe to say there is not a function in 
the whole animal economy that may not 
be coincidently more or less deranged or erratic; 
but whatever the nature and train of symp- 
toms, the name of diabetes mellitus will 
prevail, provided an excessive quantity of urine 
containing sugar is secreted, accompanied with 
the usual diabetic thirst. To enumerate and par- 
ticularize, in all the cases of functional disturbances 
that might present themselves, would require the 
space of volumes. The names of diseases are 
useful, inasmuch as they suggest to the prac- 



48 THE EYE IN ITS 

titioner of medicine, a certain combination of 
disturbed functions. When an irritation in the 
nerve-centers arises from injury, it is called trau- 
matic. When it arises from other causes than 
injury, it is called idiopathic. It makes no dif- 
ference whether the nerve-centers receive their 
disturbing cause through the one source or the 
other, they are still irritated or disturbed nerve- 
centers ; and in either event the position we have 
taken is in no way altered, that disease is always 
localized abnormal innervation. 

Various forms of catarrh are localized nervous 
derangements. The inflammation of the mucous 
membrane of the nose, ear, throat or other parts that 
are affected, is a result of a pre-existing condition, 
namely an unnatural or excessive sensibility of 
this membrane ; which simply means that the 
nerve-centers are supplying this membrane with 
nerve or motive-force of such a character that it 
takes offense at very slight changes in the tem- 
perature of the atmosphere. Again, the pollen 
and perfume of flowers sometimes give rise to hay 
fever, asthma and various forms of catarrh. All 
this is because the nerve-impulse that is supplying 
the part is so excessively abnormal in the way of 
sensibility, that things otherwise inoffensive pro- 
duce serious results. It is not the nerves that are 
affected ; they are simply conveyors of sensitive 
nerve-force. They themselves are passive and 



RELATION TO HEALTH. 49 

without feeling. It is the impulse that passes 
through the nerves that characterizes the peculiar 
irritability or hypersensitiveness of the membrane, 
and this gives rise to the inflammatory action that 
follows. 

Alcoholism is a form of abnormal innervation 
which manifests itself in an irritable craving for 
alcoholic stimulus. It is not necessary to dilate 
on the different forms of drunkenness further than 
to mention the habitual and the periodic drinker. 
The habitual drinker has a steady or fixed irrita- 
bility in the nerve-centers that gives rise to a 
constant desire for stimulus. A periodic drinker 
is one in whom there is a gradual and steady in- 
crease of irritability in the nerve-centers until a 
climax is reached. When this period arrives all 
judgment is set aside; and with the knowledge of 
previous errors staring him full in the face, even 
the death of a parent, wife or child, he insanely 
drains the cup to the bitter dregs again and again. 
The dipsomaniac is certainly insane. I have seen 
him kneel in prayer and beg for help against his 
infirmities, and truly his prayer was earnest and 
his heart sincere ; yet ere he arose from his knees, 
he drew from his pocket a flask of whiskey and 
drank deeply of it. If there are superlative de- 
grees of heartache and yearning, they are in the 
breasts of drinking men, in their burning desire 
to be free from the thraldom of drink. 



5° THE EYE IN ITS 

As to this form of derangement finding its 
origin through the visual centers, I desire to call 
attention to one prominent fact. Among various 
treatments for dipsomania or drunkenness, are 
those that involve the use of remedies usually- 
applied by hypodermic injection which causes a 
dilation of the pupils of the eyes. This dilated 
condition is usually continued for about the 
space of one month. Whatever the remedy is, it 
acts as a mydriatic. It acts by relaxing spasm 
in the ciliary muscle. It also dims the vision 
more or less, so that the stimulus to fix both eyes 
in a parallel plane with each other is lessened ; 
and if there be a short upper, under, inner, or 
outer muscle, there is but little stimulus to exert 
its strain ; also the vision is fogged, and all this 
relaxation lessens the labor of the visual centers. 
My opinion is that so-called cures for dipsomania 
perform whatever good they effect by temporarily 
relieving eye-strain. This is also verified by the 
fact that the same nervous conditions are equally 
benefited by dropping a mydriatic such as hyoscy- 
amine, hyoscine or atropine into the eye, thus 
dilating the pupil and relaxing ciliary strain, and 
at the same time lessening the acuity of vision, so 
that the stimulus for parallelism is also lessened. 
During the time the eyes are kept in this dim, 
relaxed condition, there is a cessation from eye- 



RELATION TO HEALTH. 51 

strain and the brain irritation dependent on it, 
and the craving for drink ceases ; but after the 
remedy has ceased to be administered, and the 
effect has passed from the system, there will 
usually be a return of the same old strains, induc- 
ing a return of the irritation of the nerve-centers, 
bringing back the old appetite, or at least a condi- 
tion in which the appetite is readily awakened by 
sight, taste or smell. There are natures of suffi- 
cient strength to continue an abstemious life after 
the aid of treatment has once been given them ; 
but again there are men who, when the irritation 
returns, are helpless ; their passionate impulses 
are uncontrollable. Those who are able to resist 
drink after the brain irritation returns, are often 
visited by some other form of affliction in its 
stead, such as disease of the heart, liver, kidneys, 
sexual organs or lungs. Conversely, we are often 
able to arrest and delay the progress of consump- 
tion by the use of liquor, establishing a form of 
alcoholism that utilizes those abnormal impulses 
which were performing the function of building up 
tubercular tissue ; their office is really perverted 
and the disease thus arrested. 

A man may love the taste or the smell of 
liquor, but without any effort on his part, can use 
it sparingly. He has really no appetite for it, 
although the taste and smell are pleasant to him. 



52 THE EYE IN ITS 

Again, a victim who has a vicious appetite may 
hate the taste, smell and sight, yet for his life, he 
cannot be prevented from drinking it. 

The supposition of the masses in their obser- 
vation of drinking men, is that such unfortunates 
resort to the use of alcoholic stimulus for the 
dissipation, for the pleasure they find in it ; but 
this view is absolutely incorrect. These men 
drink for the purpose of diverting the horrors 
of constantly increasing nervous irritability, 
which ultimately becomes absolutely unbearable 
and incompatible with sanity. 

Alcohol acts on the nerve-centers by first 
exalting their action, and then for a time sustain- 
ing such an extravagant call upon them that, 
sooner or later, they become absolutely ex- 
hausted and are unable to furnish any more vital 
force than is just necessary to carry on the un- 
conscious functions of life. Physical strength 
passes away, the reasoning powers take flight, 
and unconsciousness ensues, for lack of vital 
force to carry on these functions. During this 
period of prostration, all abnormal innervations 
that were a source of irritation to the brain are 
suspended. When the nerve-centers begin to 
recuperate and build up, there is a gradual re- 
establishment of those abnormal innervations or 
strains, until they are again so excessive as to be 
unbearable and a debauch is resorted to once 



RELATION TO HEALTH. 53 

more as a relief. Now by determining just 
where these abnormal innervations are, and just 
what is the cause of them, we may correct these 
strains and abnormal innervations, and thus 
relieve the patient without any risk of a return of 
the uncontrollable appetite and without the risk 
of some other disease in its stead. 

An inflammation in any part of the body is 
the result of an irritant nerve-supply to the 
affected part, whereby the sensibility of the part 
is emphasized to a higher or abnormal degree. 
The nerves of the smaller blood vessels (vaso- 
motor-nerves) carry the impulses that cause the 
derangement ; congestion follows and inflamma- 
tion ensues. 

Frequently one inflammation is relieved by 
producing another, a method that we call coun- 
ter-irritation ; e.g., by a mustard plaster or a vesi- 
cant. This establishes its inflammatory or irri- 
tant action by sending to the nerve-centers 
impulses that stimulate them to return that 
impulse that gives rise to the inflammation that 
we wish to establish. Although the result is 
local, the action of the irritant is not. Often 
has the practitioner applied a counter-irritant 
when it failed to produce the desired irritation, 
from the fact that the nerve-centers were in such 
a low and enfeebled state that they were unable 
to respond. In mumps, there is an inflammation 



54 THE EYE IN ITS 

of the parotid gland and sometimes a curious 
thing occurs ; the inflammation in the parotid 
suddenly ceases and at once makes its appear- 
ance in the testicle or ovary. This sudden 
change of the seat of inflammation from one 
part of the body to the other, not affecting any 
of the intervening spaces, has been called metas- 
tasis, and at first may look like a strange and 
unaccountable phenomenon ; but it is not diffi- 
cult to understand when we consider that it is 
that portion of the nerve-centers that presides 
over the parotid that is disturbed and sending 
irritant nerve-force to the gland, causing the in- 
flammation, and that there occurs a switching or 
change of this irritation from this nerve-center to 
the one supplying the testicle or ovary which is 
probably conveniently located for the purpose of 
change. The instant the irritation changes from 
one nerve-center to the other, the inflammatory 
action changes its location. 

Ovaritis, or inflammation of the ovaries, from 
whatever source it may have taken its origin, is 
always due to a disturbance of the nerve-centers 
that preside over the ovarian functions. 

Parturition or child-birth as well as the 
monthly organic functions of the ovaries, can 
only be exciting and not primary causes of ova- 
ritis; for if their presiding nerve-centers are vig- 
orous and generous in their supply of nerve- 



RELATION TO HEALTH. 55 

impulse, these organs always recover from dis- 
turbances excited by the above causes. But 
when they do not recover their normal condi- 
tions, the failure results from a lack of equilibri- 
um in the nerve-impulses, and ovaritis is the 
result. A long continuance of the disturbed 
conditions that interfere with the organic and 
assimilative functions of these parts, may ulti- 
mately give rise to lesions, the growth of cysts 
and tumors of various characters, also displace- 
ments due to a weakened condition of support- 
ing appendages. The pain and suffering in these 
parts is central; all feeling is in the nerve-centers, 
and only apparently located in the parts of the 
body where we seem to note it. Oftentimes 
feeling continues to exist apparently in an absent 
part which has been removed even for many 
years ; for instance a leg. But recently I asked a 
patient whose leg I amputated twenty-five years 
ago if his old gout ever troubled him in that part 
now. His answer was, "Yes, very badly; but I 
cannot get my foot in hot water as I used to, 
consequently I have to suffer the pain. Some- 
times my toes get crossed, and, not being able to 
touch them, I am unable to relieve the disagreea- 
ble feeling." The nerve-centers that once pre- 
sided over the foot were in a disturbed condition 
and caused the unpleasant feelings complained 
of. Every surgeon is familiar with such com- 



56 THE EYE IN ITS 

plaints, and they teach us conclusively that the 
feeling of all parts is in the central nervous 
system. 

All medicines or remedies are administered 
with the expectation or hope that they will cor- 
rect whatever disturbed functions the disease may 
consist of. The end sought is to reestablish nor- 
mal action in the nerve-centers and thus restore 
perfect function. Whether the nerve-center is 
influenced by impulse from without, or by remedy 
taken into the circulation and carried directly to 
the part, the action is the same. Just what 
change takes place in the nerve-centers is some- 
what a matter of speculation. We think we have 
strong reasons for believing it to consist of 
changes in polarity. 

The Homeopathic principle of administering 
remedies for disease is similia similibus curan- 
tur, (or like cures like) and is based on the fact 
that a certain remedy administered in health 
causes changes in the function of some particular 
organ or part. Now, when this part becomes 
diseased, the conclusion is that the remedy hav- 
ing a predilection to act on these parts will tend 
to restore them to normal action. Whatever 
changes are wrought originate in the nerve- 
centers. How can it be possible to disturb a 
healthy function without first disturbing the pre- 
siding center? Even in the case of injury to a 



RELATION TO HEALTH. $1 

part, inflammatory action does not ensue until 
the nerve-centers have received the irritant impulse 
from the shock or injury; and then they return their 
characteristic impulses to the injured part, estab- 
lishing the inflammatory action which, under 
favorable circumstances, tends to repair the 
injury. 



58 THE EYE IN ITS 



V. 



WE step upon a rough pebble. It hurts. 
The fact is, that when the nerves of any 
part of the body come in contact with any sub- 
stance with sufficient force, that contact produces 
an impulse or current which traverses the nerves 
to the brain or central nervous system. This cur- 
rent sent from the outside or periphery to the 
central nervous system, is called an afferent cur- 
rent. The nerve-center receives this afferent 
impulse, and responds by generating and sending 
back to the parts and their surroundings that 
were originally interfered with, a current or 
impulse which is called an efferent current; it is 
also called reflex, being sent back as an image of 
an object is sent back from a mirror. In medical 
practice we meet with many serious disturbances 
arising from what we call reflex causes. 

Frequently has it occurred in the experience of 
the dentist, that in removing a diseased tooth, he 
has also removed the immediate cause of a 
serious neuralgia, some form of headache or other 
nervous disorder; the gynaecologist records many 
instances where displaced organs have been the 
cause of reflex diseases in other parts of the body; 



RELATION TO HEALTH. 59 

the catarrh specialist has found enlarged or 
hypertrophied turbinated bones to have been the 
cause of serious reflex diseases; the rectal 
specialist has recorded many important cures of 
various diseases in other parts by the relief of 
some local disease. Pathology records similar 
reflex diseases to an extensive degree and also 
relief by a correction of the local disturbance ; 
and the latter has sometimes been regarded as 
the primary cause of the reflex disease, but this 
conclusion is in all cases erroneous. For 
example, let us suppose that ovaritis gives rise to 
some reflex disease; the fact that the ovaritis is 
itself the result of some prior cause shows that, 
as a causative agent, it cannot be primary. So 
numerous have been such cases and their relief 
through each separate branch of orificial surgery, 
that some in each department have become so 
enthusiastic as to believe that nearly all diseases 
find their origin through the disturbances found 
in their particular line of work. Any and all of 
these views, taken at first sight and considered 
separately, have apparently much evidence in 
their favor; but that they are all erroneous is 
evident from the fact that while these reflex 
troubles had resulted from the special diseases 
which were treated, these special diseases them- 
selves must each have had a cause which must 
still be accounted for. Consequently, any theory 



60 THE EYE IN ITS 

which relies on some diseased condition as the 
fundamental factor in the origin of disease, must 
necessarily be wrong, from the fact that the pri- 
mary disease is itself still unaccounted for. 

I wish to be distinctly understood as advo- 
cating the importance of correcting all such 
disturbances locally, as well as removing the 
cause of their origin. The relief that is af- 
forded by giving them attention, is in many cases 
truly wonderful. What I wish to point out par- 
ticularly is : the origin of the local disturbance, 
for it may be a secondary or tertiary cause of 
reflex ; and if we do not dip still further into the 
mystery of our trouble, that which was the pro- 
moter of the primary local disturbance will turn 
in some other direction and continue its devasta- 
tion of the nerve-centers, and the patient, although 
from time to time relieved of various local diffi- 
culties, will be forever a sufferer. This is fairly 
substantiated by the cases of a large number of 
nervous women who have submitted to a removal 
of the ovaries for the relief of nothing more than 
chronic ovaritis. If the patient recovers from 
the operation, it is usually recorded as a success- 
ful one. True, the local disturbances have been 
relieved, as rheumatism in the leg would be by 
amputating the limb ; but the central irritation 
that gave rise to it generally continues and 
expends its fury in some other direction. At 



RELATION TO HEALTH. 61 

least, this has been my observation in no less 
than eighty-four cases. This unsexing of women 
because of no other disorder than chronic 
ovaritis, will in a great majority of cases be 
abandoned ; for a more perfect general relief from 
these troubles will be found in less stringent 
measures. Clinical experience has repeatedly 
demonstrated the truth of this statement. 

Every local disturbance, to whatever specialty 
it belongs, has some cause back of it, some ab- 
normal nerve-impulse that gives birth to the 
unnatural conditions. In rectal disease a consti- 
pated habit exists which in itself is simply a 
lack of impulse to perform the functions of the 
bowels. 

Habitual constipation is always an evidence of 
nerve-center derangement, a condition in which 
there is a failure of the dynamic-center to send to 
the bowels a sufficient amount of motive-force to 
perform the function of absorption, secretion and 
muscular action, necessary to carry on the daily 
offices of health in these parts. The derangement 
is in the nerve-centers, and any relief that is 
obtained from this condition must always be 
obtained by regulating the action of the nerve- 
centers that govern the bowels. A pill or any 
cathartic is taken into the mouth, and passes on 
through the stomach into the intestines. Its 
presence there acts as an irritant which sends an 



62 THE EYE IN ITS 

afferent impulse to the nerve-centers ; from 
thence is reflected an efferent impulse that car- 
ries to the bowels a working motive-force that 
sets their various functions in motion and an 
action ensues. Often has the medical practitioner 
met with a case of constipation existing in con- 
nection with some serious disease that has 
resisted the action of the strongest purgatives ; 
locally, these remedies have reached the bowels ; 
but the low, disturbed state of the nerve-centers 
has been such that they have not been awakened 
to respond to the irritant impulse, which was sent. 
Sometimes constipation will be the only promi- 
nent local defect in general nervous derangement. 
In many cases, we find constipation coexistent 
with general nervous debility and various forms 
of local derangement ; but it may always be con- 
sidered a nerve-center derangement and the 
opposite of chronic diarrhoea, which is due to an 
excess of motive-force to the bowels from irritant 
causes. When the motive-forces or impulses 
proceed from healthy nerve-centers and pass 
along the nerves that carry them to the entire 
digestive apparatus, there is perfect secretion, 
perfect digestion, perfect absorption and perfect 
daily movement constituting health in these parts. 
It is the lack of such innervation in some part or 
parts which gives rise to the various distur- 
bances. 



RELATION TO HEALTH. 63 

The secretion or manufacture of the various 
constituent parts of the digestive fluids, such as 
pepsin, diastase, lactic acid, hydrochloric acid, 
bile, in short all organic products, is the direct 
outcome of the peculiar nature of the nerve-im- 
pulses to the various organs, and is largely char- 
acterized by the peculiar form and structure of 
the parts that do the work. These are the little 
engines, and any alteration in their nerve-impulses 
causes a derangement in the products of their 
work. It is easy to conceive of such an abnormal 
alteration in the motive-impulses as to produce 
uric acid and other abnormal products which are 
found in various diseases. The presence of uric 
acid is said to be the cause of certain diseases, 
whereas the truth is, that which is the cause of 
the uric acid is the primary case of these diseases; 

AN ABNORMAL IMPULSE BRINGS FORTH AN ABNORMAL 
PRODUCT. 

The results of nerve transplantation are posi- 
tive evidence that the function is not characterized 
by the peculiarity of the nerve, for we can trans- 
plant efferent nerve fibre to the place where 
afferent has been without altering the character 
or nature of the function. 

But, is there really more than one kind of 
nerve-force ? Although we speak of impulses as 
motive and sensory, or those that perform functions 
of motion and feeling, besides these we also have 



64 THE EYE IN ITS 

nerve-impulses that are performing the functions 
of assimilation, and again those that are perform- 
ing more complex organic functions. Instead of 
these varied functions being due to different kinds 
of nerve-force, is it not possible that the anatomi- 
cal or histological structure of the various parts 
in connection with an adequate supply of nerve- 
force, is that which dominates the nature of the 
function ? If so, only quantity need be consid- 
ered in all changes. 

We do not inherit disease, but we inherit those 
conditions which give rise to disease, such as 
imperfect anatomical structure of parts which, 
for the performance of their functions, require 
excessive nerve-force; also imperfectly developed 
nerve-centers, which are predisposed to localized 
irritation. Thus by heredity we may be liable to 
a particular train of diseases, such as consump- 
tion, alcoholism, diabetes, Bright's disease, vari- 
ous forms of catarrh, with a tendency to that 
weak condition which especially renders one a 
victim to malarious and contagious diseases. 

"Tubercular consumption is not a local but a 
constitutional disease, and calls for general treat- 
ment. Tubercle bacilli do not and cannot cause 
consumption in a perfectly healthy individual, 
They induce disease only in persons with lowered 
vitality, who thus become susceptible to their 
influence." 



RELATION TO HEALTH. 65 

The most prominent pathological change in 
motor-ataxy or tabes dorsalis is located in the 
spinal cord. Tabes dorsalis is not, as has been 
carelessly affirmed, the cause, but it is one of the 
results of disease ; and the changes in the spinal 
column are due to causes anterior to them, affect- 
ing the nutrition of these parts, and the sclerosis 
follows. I speak particularly of this, because we 
are frequently prone to select some predominant 
pathological condition of a disease and attribute 
the disease to that as its cause, whereas it is only 
one of its results, concomitant conditions, or prom- 
inent lesions. But these pathological conditions 
may act as causes for the establishment of still fur- 
ther reflex diseases, producing localized disturb- 
ances that act as secondary reflexes, the influence 
going further and further until we have reflex 
causes quite a number of removes from the pri- 
mary. 

The fact that great relief has followed the cor- 
rection of local disturbances of the rectum, female 
organs, nasal passages and local irritation of other 
parts of the body, all of which are abnormal 
innervations, ought to lead us to expect even 
greater relief from the correction of an abnor- 
mal innervation through the visual centers, for 
they are much more acute than any of those 
nerve-centers that preside over and govern the 
action of other parts of the body. 
5 



66 THE EYE IN ITS 

In determining the cause of a disease, it is 
very important to discriminate between exciting 
and predisposing causes, for we commit an error 
in resting our judgment on some exciting cause 
as being the sole element of the disturbance. 
This can always be laid down as a wrong conclu- 
sion where the same or a similar exciting cause 
fails to bring about universally similar results. 
If the same exciting causes are brought to bear 
on two persons and one is affected by them and 
the other not, there is somewhere a difference in 
the two individuals. There is a predisposition in 
one which causes him to yield to the exciting 
causes. In the other the predisposition does not 
exist. Whatever may be the disease arising from 
an exciting cause, this reasoning will hold good. 

Exciting causes may be a draught of air, wet 
feet, exposure to cold, the monthly physiological 
processes in women, pregnancy, over-exhaustion, 
poisonous gases, malarial and infectious germs, 
injuries, excitement, grief, poisonous drugs of 
various kinds, opium, cocaine, bromides, mercury, 
lead, alcohol, tobacco, and quite an extended list 
might be made. The action of any of these 
is emphasized by predisposing causes ; for a large 
class of individuals in a general sense have 
immunity from the effect of some of the above 
causes especially the after effects of narcotics and 
poisons. Any investigation of a disease is remiss if 



RELATION TO HEALTH. 67 

it stops at exciting causes. Acting in conjunction 
with predisposing causes there may be several 
exciting causes that give rise to a disease and its 
continuance. A general neurasthenic condition 
will be a predisposing cause; and tobacco, alcohol, 
malaria, over-work, change of life and exposure 
to cold may all be exciting causes in bringing on 
a disease. Because we have found one prominent 
cause for a disease, we should not relax our search 
for others. 



6S 



THE EYE IN ITS 



VI. 



1 T'ACH eye has seven muscles which perform all 
-■— ' the movements necessary in the functions of 
vision. Four of them are called recti or straight 
muscles, as follows : the superior rectus muscle 




EYE MUSCLES. 

i. Ciliary muscle (within the ball). 4. Superior rectus. 

2. Internal rectus. 5. Inferior rectus. 

3. External rectus. 6. Superior oblique. 

7. Inferior oblique. 

turns the eye upward, the inferior downward, the 
external outward, the internal inward or toward 
the nose ; two are called the superior oblique and 
the inferior oblique, the offices of which are to 
rotate the eye on its antero-posterior axis. The 
seventh is the ciliary muscle which is within the 
eye-ball and surrounds the crystalline lens. Some 
of the above mentioned muscles are assisted in 
the performance of their functions by other mus- 
cles. This is explained at length farther on. 



RELATION TO HEALTH. 69 

When we think of the complex arrangement 
of these muscles in the two eyes, we must know 
that for the easiest possible vision, it is necessary 
that they should be absolutely perfect as to length 
and their attachments ; also that the crystalline 
lens should be anatomically correct. Here we 
have in the two eyes, sixteen anatomical parts 
that must be without fault. This naturally leads us 
to infer that the perfect eye is an exception, and a 
wide experience has taught us that irregularities in 
in some of these parts are very common. It would 
be marvelous if one pair of eyes in a hundred were 
absolutely balanced without the intervention of 
nerve-impulse to overcome some slight defect. 
These muscles are often so imperfect in length and 
irregular in their attachments, as to cause the eyes 
to deviate many degrees from the normal position. 
When the axes of vision deviate so far that it is 
impossible for the nerve-impulses to pull them 
back into line, we have a condition commonly 
known as strabismus or squint. The deviation 
may be outward, inward, upward, downward, or a 
combination of two of these directions. When 
the angle of deviation is so great that it cannot 
be corrected by the nerve-impulses that operate 
these muscles, the effort to produce single vision 
becomes more or less suspended and the laborious 
work of the nerve-centers is abandoned. Usually 
one of the eyes suppresses its vision; for, as long 



7© THE EYE IN ITS 

as double vision of the same object exists, there 
will always be an effort to fuse the two images 
into one for the sake of avoiding confusion and 
increasing the sense of sight. 

Defects in various parts of the eye, including 
the muscles as to their length, may exist to a 
very considerable extent and yet the function of 
vision be perfectly performed. Some of the mus- 
cles may be so short that they would cause the 
optic axes of the two eyes to deviate many 
degrees if it were not that the opposite muscles 
pull them into a normal position, through the 
intervention of nerve-impulse. Nerve-impulse is 
also the primary factor in causing the ciliary mus- 
cle to contract around the crystalline lens, increas- 
ing its refractive power when it is deficient. Just 
how fixed and permanent, through a long lapse of 
time, these nerve-impulses may become, acting as 
masks to anatomical defects, is the object of our 
chief inquiry. 

Eyes that perfectly perform the function of 
vision may have hidden defects to an alarming 
extent and in proportion far greater than the 
novice would expect. Some little evidence in 
this direction can be had from the following : I 
do not believe that full suspension of abnormal 
innervation takes place in blind eyes, but suspen- 
sion does to a certain extent. Through a period 
of many years, I have been observing the eyes 



RELATION TO HEALTH. 71 

of the blind with the especial purpose of noting 
their relative positions, and I cannot recall one 
individual case in which the optic axes had not 
deviated in some direction. 

A similar condition of affairs exists in the 
eyes of a new born babe. One or more mus- 
cles may be defective as to length. Whoever 
has watched the eyes of these little ones has 
noted how aimlessly they wander about during 
the first few days, until finally the stimulus for 
fusion causes them to fix their vision ; and then 
for the first time, the two eyes begin to look in 
the same direction and so continue. 

"The eyes of new born infants are almost in- 
variably hypermetropic." (Berry.) This being 
true, it is the long continued effort of the ciliary 
muscle that brings about the emmetropia of later 
life, which is so firmly fixed, that even mydriat- 
ics sometimes fail to discover latent hyperopia. 

In fourteen autopsies, not one exception was 
found to the unequal development of long mus- 
cles. In eleven of these cases, the superior 
rectus in the right or left eye was thin, tendonous 
and undeveloped, giving evidence of having been 
on the stretch, while that of the other eye was 
invariably a well developed muscle, and the con- 
verse condition of the inferior muscle was always 
found. In two of these eleven, the external 
muscles were undeveloped, while the internal 



72 THE EYE IN ITS 

showed a high state of muscular development. 
In one of the remaining three, a habitual drunkard 
and suicide, the internal muscles were thin and 
tendonous, the externals being highly developed; 
in the other two, the externals were simply thin, 
attenuated tendons, the internals being highly 
developed. The superior and inferior muscles in 
the last three cases were so poorly developed 
that they gave no evidence of any relative dif- 
ference. A more general inquiry and a larger 
experience than I have had the fortune to 
acquire in examining the ocular muscles and the 
positions of the eyes of the dead, will bring out 
much valuable evidence in this field which as yet 
is comparatively new. 

Look into the dim windows of the brain 
twenty-four hours after death, and a deviation of 
the eyes from a perfect position will always be 
found. This evidence is also against the theory 
of muscular weakness or paresis as a general 
cause for the deviation of the eyes, for in death 
no innervation exists, and no relative strength or 
weakness. They naturally fall into the positions 
that the relative lengths permit them to assume. 
Even then the full defects do not become mani- 
fest, for the long stretched muscle will yet be too 
long ; but all this information comes too late for 
the life which is ended. Too late for aught 
but an apology for perhaps many a cen- 



RELATION TO HEALTH. 73 

sured weakness, which, after all, was no more 
than the manifestation of some physical infirmity 
for which the victim was morally blameless. 
Under infirmities thus insidiously induced, but as 
resistless as the lightning, a Dr. Jekyll becomes 
a Mr. Hyde. Let us judge justly of the infirmi- 
ties of man or judge them not at all. The ten- 
dency OF A PERFECT BRAIN IS TO A PERFECT 

body and a perfect life. The perfect devel- 
opment of a brain or any part may be pre- 
vented by the existence of some irritant cause. 
People with disagreeable dispositions and habits 
are not always responsible, as their peculiar- 
ities are possibly the result of abnormal nerve- 
impulses over which they have no control ; and 
such people should excite our kindliest feelings 
rather than our condemnation. 

Several years ago I was called from a great 
distance to see a patient suffering from what was 
at times a severe craving for alcoholic stimulus. 
During this period excessive amounts of liquor 
were drunk, the debauch continuing about one 
month. His dissipation was as deep as possible. 
After this followed the period of sobering. Then 
for three or four months he would again lead a per- 
fectly abstemious life. He was notably kind and 
generous to the poor ; lent great aid to moral 
institutions; was a kind, good father and husband, 
and seriously devoted to the church. It was at 



74 THE EYE IN ITS 

the conclusion of one of his sprees that I reached 
his home too late to see him alive. On the fol- 
lowing day, the thought came to me that if 
eye-strain had had any connection with his 
infirmity, it perhaps might manifest itself after 
death; so, in the company of his old partner 
and friend, and two undertakers, I carefully 
raised his eyelids. The left was fixed in a nor- 
mal position, the right was turned upward fully 
twenty-two degrees. Such evidence ought to 
be a sufficient explanation and vindication of 
many acts that may have incurred censure during 
life. 

The average person of middle age whose eyes 
are apparently perfect, may be seated behind an 
8 deg. prism, base down, when at twenty feet a 
light will appear as two lights, one directly over 
the other or vertical. According to the prevail- 
ing idea, this indicates that the eyes are balanced 
as far as the lateral or external and internal 
rectus muscles are concerned. Now, if this bal- 
ance depends upon the anatomical length of the 
muscles, the following test would indicate it; but 
it does not. I place on the patient in trial frames, 
say 6 deg. of prism, base out; I direct the patient 
to look around the room for a few minutes; I 
now renew my test with the 8 deg. prism, base 
down, while the 6 deg. prism is still on the 
patient. One of the two lights still appears to be 



RELATION TO HEALTH. 75 

directly over the other. We are now certain that 
we have 6 deg. of prism unaccounted for by the 
test. Sometimes we are able to put as high as 
twenty or even more degrees of prism over the 
person's eyes, base in or out, as just described, 
and after they have been used for an hour, more 
or less, the two dots or lights in the test will 
still appear to be vertical. If it had been only 
the length of the muscles with which we were 
dealing, and the lateral muscles balanced with- 
out prisms, when we put on 6 deg. of prism, base 
in or base out, we ought to have found the dif- 
ference in length by the irregularity in the 
position of the lights; but in such cases the dif- 
ference does not appear in this way, and such 
experiments clearly demonstrate how uncertain 
all diffusion tests are. Long trained, and more 
or less fixed abnormal nerve-impulses will hide 
defects from these tests that would otherwise 
cause the eyes to deviate many degrees. 

Now, if this tendency to single vision asserts 
itself with such alacrity and certainty under an 
artificially created irregularity, how much more 
would the constant effort of years working and 
pulling against a muscle that is too short, have a 
tendency to hide the defect from all diffusion 
tests? 

The various disturbances taking their origin in 
the visual nerve-centers from eye-strain, have 



76 THE EYE IN ITS 

been doing their devastating work, have been gen- 
erating from the very time of birth, from the 
very hour the two eyes first began to train together, 
those conditions that are conducive to disease. 
From that moment, nerve-force waste and brain 
irritation with its correlated consequences began. 
It is true, in certain cases, that some of the most 
distressing symptoms of disease are often relieved 
immediately on a correction of the abnormal 
innervation; but it stands to reason that the 
greater portion of disturbed conditions, which 
have been so many years in assuming definite 
form, will require patience and time for perfect 
relief. A new established order of things must 
be set up. The various nerve-impulses that per- 
form their characteristic functions must all be 
changed. The centers that generate this force 
and the avenues they travel, must all be differen- 
tiated. A new correlation has to be established, 
and sufficiently long established to maintain a 
permanency of the new and desired condition of 
affairs. If in six months, a year or more, the 
impulses from the nerve-centers have become so 
altered as to turn aside some disease where death 
was imminent, we can well say that the patient 
and the physician have been well rewarded and 
that the time was short, although the patience of 
both has been severely taxed. 

The immediate relief of pain that sometimes 



RELATION TO HEALTH. 77 

follows the application of glasses or operations, 
must not be considered infallible indications 
of a speedy cure. Such a relief is simply an 
indication that we are proceeding in the right 
direction ; and, although a pain may be stopped, 
or a prominent and alarming symptom subju- 
gated, before perfect health is restored there are 
other fully as important changes to take place 
which will require a space of months and perhaps 
years. Often serious diseases or conditions exist 
that are accompanied by no prominent symptoms 
of pain ; nevertheless they are as emphatically 
threatening life. Where disturbed brain centers 
have been for years furnishing imperfect motive- 
force to perform the various functions through- 
out the body, the functions become more or less 
enfeebled. Their structural assimilation has been 
imperfect. " In such a case, when pain is relieved 
by a change which we have wrought in the 
nerve-centers, we must expect to wait some time 
for the permanent establishment of those motive- 
impulses that normally control assimilation and 
organic functions. It takes time to rebuild that 
which has been many years in breaking down. 
We are apt to become enthusiastic when sud- 
denly relieved of some pain or alarming symp- 
tom ; but the process of reconstruction that fol- 
lows the new supply of vital force is a slow one ; 
we are not conscious of it from day to day ; we 



78 THE EYE IN ITS 

can realize it only after a much longer lapse of 
time. If these changes are carefully noted 
through periods of several months, more or less, 
we can become calmly conscious that years will 
be slowly added to life. The good that follows 
repression may possibly keep on building up and 
restoring for a space of years. The sustaining 
power of repression is well established in such 
cases as Nos. 5, 16 and 17, pages 95, 113 and 
114. 

In the slow development of latent eye defects, 
we learn how obstinate and unyielding long es- 
tablished abnormal nerve-impulses are, how they 
repeatedly persist in their endeavor to return 
during development after we have held them 
more or less repressed for several months. We 
have a correspondingly new state of affairs estab- 
lished, a changed condition of innervation which 
is young, and more or less uncertain. We 
may be somewhat prepared to expect at times a 
temporary return of the old impulses, especially 
when the nerve-centers have been subjected to 
exhaustion, or when their equilibrium is disturbed 
by alcoholic stimulus, or by an exhausting 
debauch in any direction. Under such condi- 
tions the new ocular correlation will become tem- 
porarily confused, which plainly indicates a need 
of rest, but after a time this confused state ceases 
to present itself. 



RELATION TO HEALTH. 79 



VII. 

A SHORT muscle on examination by diffu- 
sion tests may present itself in four differ- 
ent ways. 

First. It may be wholly manifest, in which 
case any and all tests will give like results. 

Second. It may be partly manifest and 
partly latent to the test. 

Third. // may be absolutely latent with no ma?i- 
ifest defects. 

Fourth. Spasm may cause the eye to manifest 
the reverse of the anatomical co?idition, i?i which case 
the eye will deviate in a direction opposite to that of 
the short muscle. This is the da?igerous condition 
that I have elsewhere pointed out. 

The first four of the following cases are given 
as illustrations of the four forms of eye-strain, 
respectively. 

Case. i. Presented by the president of the 
Johnston Optical Co., of Detroit. Left eye 
turned upward 20 deg. above the right. While 
reading, writing or looking intently at any near 
point, the inferior muscle of the left eye drew it 
down to a level with the other ; but when not so 
employed or while looking off into the distance 



So THE EYE IN ITS 

or holding ordinary conversation, the nerve-cen- 
ters would invariably relax their effort and the 
eye would turn upward fully 20 deg. into a posi- 
tion of perfect rest ; so, the greater part of the 
time there was no strain in this case, no constant 
waste of nerve-force, no unremitting source of 
brain irritation ; consequently this person suf- 
fered little or no disturbance of the nerve-cen- 
ters. He was calm, quiet, and generally free 
from ailment. No correction was made as 
the person felt no necessity for it. 

The following cases were treated by repres- 
sion. They are selected for the purpose of set- 
ting forth some of the most prominent features 
of the treatment in which tenotomy and muscle 
advancement are often necessary. Sometimes 
the desired results are arrived at without an oper- 
ation, the repression being effected entirely by 
glasses. 

When prominent symptoms of a disease have 
been subdued, we are naturally led to believe 
that our work in repression is more or less com- 
plete ; but it has so often proved incomplete on 
later examinations, that it is never safe to draw 
such conclusions. This will be clearly illustrated 
in the following case from Dr. Stanley of Brant- 
ford, Ont. In any particular case treated by 
repression alone, the only satisfaction we can 
have is to know that we have proceeded suffi- 



RELATION TO HEALTH. 81 

ciently far to establish a more perfect and hap- 
pier condition of previously disturbed functions. 

Case 2. Partly manifest; D. A., age forty; 
Dr. Stanley of Brantford, Ont, says this case has 
been under his observation for upwards of four 
years ; that from the first it was a very active and 
marked case of diabetes mellitus, and, toward the 
latter end of this period, neither diet nor medical 
remedies seemed to make any impression in less- 
ening the gravity or reducing the prominent 
symptoms. I saw the case first on October io, 
1889. Specific gravity, 1.052; thirst unquench- 
able ; voided twenty pints of water in twenty-four 
hours ; sleep broken and restless ; obliged to get 
up four or five times during the night ; anxiety 
and general nervous symptoms very depressing ; 
skin dry and scaly. 

No hyperopia was found by dropping a two 
grain solution of atropine into the eyes twice a 
day for one week ; then increasing to four grains 
to the ounce, it was used for three days, and on 
examining the eyes again I still found no indica- 
tion of hypermetropia. Vision without the glasses 
was twenty-twentieths or normal. I prescribed a 
+ 1 D glass for outdoor use, which gave twenty- 
fiftieths of vision at twenty feet. For house, 
reading, writing and all close purposes, I pre- 
scribed a -f- 4 D, which was 1 D more than an 
absolute suspension of accommodation at thirteen 
5 



82 THE EYE IN ITS 

inches. This rendered the patient artificially 
myopic. At the expiration of three months, 
through the I D glasses at twenty feet, vision 
was twenty-twentieths. On removing the glasses, 
vision was also normal, but on returning them 
to the eyes again, the vision through the glasses 
was now reduced to twenty-thirtieths, but in half 
an hour it was again twenty-twentieths or normal. 
I now increased the power of both pairs of 
glasses .75 of a dioptre, which again gave twenty- 
fiftieths of vision at a distance, and the glasses 
for near use about the same amount of artificial 
myopia that the first pair of reading glasses gave. 
At the expiration of six months more, vision 
under the 1.75 D, at twenty feet, was normal. 
On removing these glasses, it now required some 
five minutes for normal vision to take place, indi- 
cating that the reduction of ciliary innervation 
was becoming somewhat fixed. The glasses were 
continued, as well as the above modus operandi, 
for a period of one year, since which time the 
patient has been wearing -f- 2.75 for all general 
purposes. With these glasses vision is twenty- 
twentieths at all distances, but for the purpose of 
resting the accommodation, a + 5 D is frequently 
resorted to for long and continued close work. 
This ciliary repression was carried on during the 
treatment of the long muscles, which was as 
follows : 



RELATION TO HEALTH. S3 

Created horizontal diplopia ; found the supe- 
rior and inferior rectus muscles balanced. Ver- 
tical diplopia disclosed 3 deg. of convergence. 
Sufficient prism to make up for the convergence 
produced no change in symptoms. On the sup- 
position that the manifestation was correct, which 
it proved to be, and that an unknown quantity of 
latent defect might be in the same direction, I 
gradually increased the prism, base out, until, 
within an hour, under 30 deg. of prism, the intol- 
erable thirst had entirely disappeared ; the feet, 
which had been constantly cold, became warm ; 
from a sallow paleness the complexion became 
flushed and ruddy ; the pulse was reduced from 
no to 76. The prisms were now removed. On 
the nth, the tests were repeated with similar 
results as on the previous day. On October 12 
the patient could diverge for 12 deg. of prism, 
base in. These were kept on the patient in this 
position for nearly two hours. All distressing 
symptoms were very much aggravated until the 
patient exhibited great uneasiness and alarm. 
The hands and feet were cold, the complexion 
very pale, while the pulse mounted to 130. The 
prisms were removed, and an unusually uncom- 
fortable night followed. On the 13th, 30 deg. 
of prism were again accommodated for, and 
worn for two hours. A general relief followed. 
At this time, the 30 deg. proving somewhat tire- 



i>4 THE EYE IN ITS 

some to the eyes, I reduced the prism to 20 deg., 
which the patient continued to wear for one week. 
The thirst did not return, the nights were some- 
what more comfortable, the quantity of water re- 
duced to ten pints, while the circulation and 
warmth in the extremities were considerably en- 
hanced. On now adding 20 deg. more of prism 
temporarily, a perspiration appeared on the fore- 
head and other parts of the body, the first the 
patient could remember having had for nearly 
four years. 

Partial tenotomy was now performed on each 
internal rectus muscle, leaving but a few of the 
outer fibres. I now had 4 deg. of manifest 
divergence, but the symptoms were not so mate- 
rially relieved as they had been under the prisms; 
he could still accommodate for 40 deg., base out. 
Twenty degrees were constantly worn, base out, 
for two weeks following this, at which time I 
made a complete division of both internal tendons, 
not detaching them from the capsule. Under 
diplopia I now had 16 deg. of manifest exophoria. 
Vision was single to within a distance of about 
fourteen inches, but diplopia existed for all dis- 
tances nearer. The repression in the external 
muscles was now considerable ; the thirst was 
entirely gone and the daily quantity of water 
reduced to seven pints; gravity 1.035; ^ eet warm; 
skin moist ; cheerfulness came ; sleep more con- 



RELATION TO HEALTH. 85 

tinuous and refreshing. The gravity was reduced 
slowly and was at times variable. On the first of 
May following, it was 1.020. On the 4th of July, 
1890, gravity was 1.016. All tests now failed to 
find the slightest trace of sugar. Repeated ex- 
aminations at various times through a space of 
four years have resulted in finding no sugar. 
Perfect health has prevailed. Patient paid me a 
visit in September, 1894, having been through a 
year of tedious work, with some very harassing 
reverses. Was feeling somewhat depressed and 
nervous; specific gravity 1.020; no trace of 
sugar; no other diabetic symptoms. 

By diplopia, the lateral eye muscles were per- 
fectly balanced as well as the vertical. By differ- 
ential test, namely prism base down before one 
eye, then the other, the patient was able to 
accommodate for several degrees more of prism 
on one eye than on the other. I at once began 
repression in this direction, and in one week the 
patient was wearing 14 deg. of prism base down 
before the right, or divided between the two 
eyes, with a perfectly satisfactory relief from 
nervousness and depression. The color of the 
skin was very much improved. 

To be certain that these changes were due to 
the above repression with the 14 deg. of prism, I 
at once reversed it. In the course of two hours 
the patient was able to fuse for 10 deg. in the 



S6 THE EYE IN ITS 

opposite direction. The complexion turned pale, 
the pulse mounted to 96, the hands and feet grew 
cold, and a very nervous and excited condition 
ensued; in ten hours the test of the urine showed 
sugar; gravity 1.038. The patient was very much 
alarmed. I immediately reversed the prisms. 
Nevertheless, a restless night was spent. Gravity 
was 1.030 in the morning, but by evening it had 
fallen to 1.020. On the following day it was 1.018 
with a perfect alleviation of the disturbed con- 
ditions. 

I now made a complete division of the 
superior rectus of the right eye, not detaching it 
from the capsule. This eye was now thrown 
below its fellow 6 deg., vision was easy and 
single with the head slightly elevated. On look- 
ing upward there was double vision. At the end 
of three weeks no inconvenience from double 
vision remained and the patient's condition was 
in every way satisfactory. A letter was received 
from the patient seven months after the last 
operation, all conditions of health being reported 
perfect. 

This and many other cases that can be shown 
prove that, although the prominent symptoms of 
disease may be entirely relieved, as this diabetes 
was for a space of over four years, considerable 
abnormal innervation may still exist. The fact is, 
our first operations relieved the nerve-centers suffi- 



RELATION TO HEALTH. §7 

ciently to place the diabetes under subjection; but 
during all this time a considerable abnormal 
innervation was existing. The exceeding promi- 
nence of the defect in the lateral muscles was 
sufficient to hide completely that existing in the 
vertical direction. It might have been found 
had it been looked for after the first operations, 
but the improvement in the general conditions 
naturally led us to suppose that we had done all 
that was necessary. 

I look upon the above as in no way a stubborn 
case. The abnormal innervations yielded very 
readily to the repression. The abnormal inner- 
vation giving rise to tonic spasm is sometimes 
so stubborn, that it fails to yield at times, even 
for months. Then suddenly it will relax and 
advance rapidly into high degrees bringing 
marked relief. This will be found illustrated 
clearly in case No. 19. 

Case 3. Absolutely latent; M. S. M. twenty- 
nine years old; married ten years; highly intellec- 
tual; graduated from a collegiate course at the 
age of eighteen with the highest honors; had 
always been a bright, vivacious girl, but was of a 
somewhat excitable nature. Had always been 
inclined to a constipated habit; at the age of 
twenty-two began to suffer with occasional pains 
and local disturbances in the region of the ovaries, 
and this condition continued to increase until it 



88 THE EYE IN ITS 

became an almost constant source of suffering. 
At the age of twenty-seven other complications 
set in, neuralgic pains in the upper portion of the 
spine, also in the dorsal region. She now had a 
constant desire for water, ices, or cold drinks; 
was voiding large quantities of water, being 
obliged to get up two or three times in the night 
for that purpose. Her case was diagnosed as 
diabetes depending on chronic ovaritis, and in 
council a removal of the ovaries was advised. 
Preparations were made for the operation, but, 
through dread, it was abandoned. At about the 
time she visited me, she had again decided to 
undergo the operation. I found the specific 
gravity of her water 1.044, eighteen pints in 
twenty-four hours, perfectly clear and free from 
color; thirst quite marked; the smell of acetone 
was very perceptible in the breath; skin dry and 
scaly. She was excessively nervous and irritable. 
I created diplopia with prisms which at twenty 
feet gave no indication of any irregularity in any 
of the eye muscles; vision was normal at both far 
and near points. Could converge for 40 deg. of 
prism, and diverge the optic axes for only 6 
deg. At the near point, vertical diplopia gave no 
evidence of any irregularity in the lateral muscles. 
While under the converging prisms, base out, 
her thirst and nervousness were aggravated, so I 
reversed the prisms to base in; causing the eyes to 



RELATION TO HEALTH. 89 

diverge 6 deg. A perceptible relief followed. 
Founding my judgment on this test, I now began 
repression of innervation to the internal muscles, 
by having her wear 6 deg. of prism, base in, for 
distance, and when reading 20 deg., base in, in 
connection with a +3D glass for suspending the 
effort of accommodation. The thirst was sub- 
dued almost at once, and the nervous symptoms 
markedly relieved. On the following day she 
was able to wear 8 deg. of prism, base in, without 
creating much double vision. At the end of one 
month, by gradual repression, she was able to 
tolerate 20 deg. of prism, base in, without creating 
diplopia. During this repression, the pains in 
neck, back and ovaries were greatly diminished, 
and the constipation was entirely relieved from 
this time on. 

On removing the glasses, I now had a highly 
manifest case of exophoria. By the finger test, 
approaching it close between the eyes, I found 
the right eye less inclined to converge. I made a 
complete division of the tendon of the external 
muscle of the right eye on the immediate line of 
its attachment to the sclerotic, after which there 
still remained a manifest exophoria of 3 deg. by 
diffusion test. I continued repression in the same 
direction, in ten days again arriving at 14 deg. of 
prism. I now made a complete division of the 
tendon of the external muscle in the left eye. In 



9° THE EYE IN ITS 

neither operation was the tendon detached from 
the capsule. After the last operation, all symp- 
toms were materially relieved ; the thirst was 
entirely gone ; the amount of water voided was 
now five pints with a specific gravity ranging 
from 1.026 to 1.030; the pains in the ovaries, back 
and neck were gone. The only disagreeable 
feature to the patient now was that my last oper- 
ation had turned the eyes inward 10 deg., and for 
a time all objects were seen double. I now 
placed on her eyes sufficient prism, base out, to 
bring about single vision again. I decreased this 
prism 1 deg. at a time, varying through a period 
of two weeks, at which time she was able to see 
objects properly, directly in front of her, but on 
turning the eyes either to the right or left, they 
would again appear double. 

I continued the repression process by putting 
on 1 deg. of prism, base in, then two, letting her 
wear each change until fusion had taken place. 
This I continued until she was able to accommo- 
date for 8 deg., base in, which was in about three 
months from the last operation. On now remov- 
ing the prisms, easy single vision was possible 
directly in front and to both sides sufficiently far 
to be perfectly practicable. 

Six months after the last operation, every trace 
of sugar had disappeared from the secretions, the 
quantity was normal, and not a trace of ovaritis 



RELATION TO HEALTH. 91 

or spinal irritation was left. The general health 
was admirable. 

It is true this patient was obliged to suffer 
considerable inconvenience and annoyance during 
the treatment. The double vision was unpleasant 
and perhaps alarming to the patient and friends, 
but the result far more than counter-balanced all 
these trivial annoyances. A dangerous capital 
operation was avoided, and health and happiness 
restored. 

One year after this patient left my care, she 
gave birth to a healthy eight pound boy. Three 
years from this time, although her health had 
remained perfect, she returned for an examination. 
Artificial diplopia, both vertical and horizontal, 
disclosed a perfect balance in all the muscles. At 
this examination, finding no functional derange- 
ments, I made no further effort by repression to 
discover if abnormal innervation still existed. 

Case 4. Reverse manifestion ; woman, thirty- 
six years old ; married twelve years ; no children ; 
when a girl suffered from headaches, with pain in 
the back of the neck and between the shoulders ; 
since the age of twenty-two had gradually increas- 
ing sensitiveness and pain in both ovaries, the 
left being the worst ; habitual constipation ; at the 
age of thirty kidneys began secreting larger 
amounts of water than normal ; at this period a 
gradually increasing thirst set in ; no sugar was 



9 2 THE EYE IN ITS 

ever discovered in the secretions. An operation 
for the removal of the ovaries was seriously 
advised. The patient was determined to die 
rather than submit to it. 

Six months before she visited me, an aggra- 
vating cough set in. At the time of her first visit, 
on the twenty-second of November, 1892, the 
amount of water passed was twenty-four pints in 
twenty-four hours; specific gravity 1.002; thirst 
insatiable ; no sugar. By diffusion test the supe- 
rior and inferior muscles were apparently balanced, 
the external and internal muscles turned the eyes 
inward 4 deg. I corrected this by placing 4 deg. 
of prism, base out, on the patient. In an hour the 
prism test again showed 2 deg. more of conver- 
gence. I corrected this ; in half an hour, under 6 
deg. of prism, base out, there were 2 deg. more of 
manifest convergence. Instead of balancing this 
with prisms, I overcorrected by 24 deg. Within 
an hour all distressing symptoms were very much 
aggravated, especially the pain and thirst. I con- 
cluded from this that the manifest convergence 
was due to spasm and that the prism was increas- 
ing it. I now removed the glasses. After twenty 
minutes the patient was able to accommodate for 
4 deg. of prism, base in; in half an hour 2 deg. 
more were tolerated, increasing the divergence of 
the eyes. The thirst and pain were somewhat 
relieved. I now put on the patient 10 deg. of 



RELATION TO HEALTH. 93 

prism, base in, and sent her home for the night. 
This gave double vision for any distance beyond 
ten feet. 

November twenty-third. At noon the patient 
was able to see objects single under the 10 deg. 
prisms. I now tested with prisms at the near 
point, 12 inches, at which distance 12 deg. more 
of divergence were manifested, which made in all 
22 deg. at the near point. I now suspended 
accommodation with a +3D glass, and overcor- 
rected the entire amount of divergence manifested 
at the near point by putting on 28 deg. of prism, 
directing the patient to continue reading as long 
as possible. In a quarter of an hour the mouth 
had become moist, the thirst had entirely disap- 
peared, and the pain in the ovaries was gone. 
The distance prisms were increased to 12 deg. and 
the repression kept up at both far and near points 
for three days. The improved conditions contin- 
ued. This decided the patient to undergo what- 
ever temporary inconveniences were necessary to 
this treatment. On the twenty-sixth of November 
I made a complete division of the tendon of the 
external muscle, not separating it from the cap- 
sule. Three days later a division of the opposite 
tendon was made. The result was 16 deg. of 
manifest convergence. Double vision existed at 
all points beyond twenty inches. Vision was now 
made single by 8 deg. of prism, base out. This 



94 THE EYE IN ITS 

was reduced almost daily. At the expiration of 
ten days, vision without glasses was single, 
directly in front, but double on looking either to 
the right or left. Repression was continued with 
prisms, base in, increasing them one degree at 
a time, through a period of three months, when 
14 deg. of prism were worn, base in, with single 
vision for all distances. The amount of water 
was now reduced to five and one-fourth pints in 
twenty-four hours. The most rapid reduction was 
during the first few days of treatment. The only 
ovarian difficulty now left was, that, when the 
patient was lying on her back, she could not 
straighten her left limb without producing a slight 
pain in the left ovary. 

Sufficient divergence had taken place, so that 
I now advanced or shortened the internal muscle 
of the right eye sufficiently to give 12 deg. of con- 
vergence again. Repression was continued. At 
the end of three months, vision was single with- 
out glasses. This convergence would have cor- 
rected itself in time without the use of prisms 
but not so quickly. 

I have seen the patient occasionally through 
the space of nearly two years, and not a trace of 
the old difficulty has ever returned in that time. 

Ignorant criticism of this class of cases, 
where diplopia or double vision has been created 
for the purpose of reversing or repressing an 



RELATION TO HEALTH. 95 

abnormal nerve-impulse, has proved very injuri- 
ous to a large class of sufferers, in many in- 
stances costing life ; a criticism that is conscien- 
tious, no doubt, as many see no deeper into the 
necessities of the eyes than that their muscles 
should bear a perfect balance physically ; but 
such critics do not seem to know that physical 
balance is often sustained by an alarming degree 
of unbalance or inequality of nerve currents, that 
is destroying the equilibrium of the brain centers, 
and fast robbing them of vital forces that should 
be expended in other directions. As it is the 
abnormal impulse alone that is sapping life of its 
forces, that is disturbing the brain, we must look 
sufficiently deep to discover this disturbing force, 
and, when necessary, temporarily sacrifice the 
apparent muscular balance, which, under proper 
care, rights itself in from a few days to a few 
months. Discontinuance of the treatment in 
obedience to this criticism has often resulted 
fatally to the patient in a very few days. The 
great danger lies in the eyes remaining in that abnor- 
mally balanced condition that is threateni?ig life. 
The following cases, Nos. 5, 6 and 7, are illus- 
trative of this statement : 

Case 5. June, 1890, Mr. McL., of Windsor, 
Ont., aged forty-six, was voiding eighteen pints of 
water in twenty-four hours; specific gravity 1.044; 
thirst intense, with symptoms of portal congestion; 



96 THE EYE IN ITS 

an appearance of excessive jaundice ; very ner- 
vous; pulse 115; chronic diarrhoea. After deter- 
mining that the external muscles were short, and 
that considerable strain existed in the ciliary mus- 
cles, I began repression by relaxing one of the 
external muscles, and putting on heavy fogs at 
once (+5 D). In three days time the eighteen 
pints of water were reduced to six; the thirst was 
entirely relieved ; the jaundice color of the com- 
plexion had cleared ; much relief was experienced 
as to the portal congestion ; and the diarrhoea 
was relieved as well as the indigestion. The 
patient was able to walk but a few rods when I 
first saw him. By the end of one week he was 
able to walk two miles without experiencing any 
inconvenience. On the tenth day the specific 
gravity was 1 .032 and the patient had so gained 
in strength that he was able to walk four miles 
without fatigue. This was the last visit he made ; 
for, in his weak mental state, he was led to be- 
lieve that the changes he had experienced could 
not be the result of anything that had been done 
to the eyes. By advice, that which I had done 
was undone ; the glasses were removed, and 
superseded by a prescription of opium and atro- 
pine. The condition of the patient grew rapidly 
worse, and on the twenty-eighth day after I last 
saw him he died. 

Case 6. August 15, 1890; Mr. R., of De- 



RELATION TO HEALTH. 97 

troit ; age thirty-five ; clerk in clothing store ; 
had suffered for past two years from excessive 
melancholia ; he was nervous, irritable and his 
nights restless ; was habitually constipated ; six 
months before visiting me, he began to notice 
considerable difficulty in walking, especially in 
the dark, with a gradual and partial loss of feel- 
ing in the lower limbs ; symptoms of motor- 
ataxy developed rapidly. On his first visit he 
was unable to turn around quickly, while walk- 
ing, without great danger of falling ; was unable 
to stand with his eyes closed ; complexion pale, 
feet and hands cold. I began repression with 
prisms and plus spherical glasses. During the 
first day, considerable warmth was restored to 
the extremities and a ruddier color to the skin. 
At the end of three weeks he had so improved 
that he was able to stand, without falling, while 
his eyes were closed. There was some improve- 
ment in the walk ; he was now able to turn 
around with much less clumsiness. The im- 
provement in this case was very considerable for 
the space of two months, at which time Mr. R. 
felt able to return to his duties in the clothing 
store, which had been abandoned for three 
months previous to the treatment. 

The repression glasses were somewhat dis- 
agreeable, and during my absence in the East, 
Mr. R. was induced to abandon them and try a 
7 



98 THE EYE IN ITS 

treatment that consisted of suspension. From 
this time his condition grew worse, and at the end 
of three months he put a period to his existence 
by shooting himself. 

Case No. 7. F. G. age thirty-five; bright, 
intelligent and for several years actively engaged 
in business; suffered occasionally from ver- 
tigo and extreme nervousness. A few weeks 
previous to coming to me, on returning to his 
home one evening he was seized with dizziness, 
temporary partial loss of vision, and was pros- 
trated for several weeks, being confined to bed. 
It was now first discovered that he was suffering 
from diabetes. His devoted brother, who had 
been a patient under this treatment, went to visit 
him, and by slow stages and resting, brought him 
to me. I found his specific gravity 1.050; four- 
teen pints of water in twenty-four hours; thirst 
intense; pulse 105; unable to walk but a few rods, 
and that with great exhaustion. Repression 
rapidly subdued his thirst; reduced his gravity in 
two months to 1.024; his pulse to 75. In three 
months he had gained fourteen pounds in weight 
and enjoyed a walk of two or three miles. He 
returned to his home two thousand miles away. 
Ciliary repression was continued by a high grade 
of fogging. During a space of four months very 
bright and encouraging letters concerning his 
health were received. Riding, driving and fish- 



RELATION TO HEALTH. 99 

ing excursions were indulged in with great 
pleasure. He wrote a letter telling that he had 
been able to dance eight round dances in a night. 
This, of course, I at once advised against. A few 
days after this he had the misfortune to have all 
his glasses broken, and neglected for three weeks 
to have them replaced, at the end of which time 
he was suddenly taken ill again. Hurried corre- 
spondence by his sister followed, asking for 
glasses. Then came a telegram that he was 
much worse, and the following day another 
announcing his death. This and the two pre- 
vious cases are three only of many similar ones 
that I have known. The uplifting and sustain- 
ing power of repression is as clearly demonstrated 
in these, as in that class of cases that have 
resulted favorably. 

I do not assume that cases Nos. 5, 6 and 7, 
which resulted fatally, would have been cured 
had they continued treatment ; but as far as the 
treatment was carried, the evidence was most 
markedly in its favor. 

Where defects exist in several of the muscles, 
the defect is sometimes so prominent in one as to 
hide completely the defects in the others, which 
only manifest themselves to us after a correction 
of the first. The reasons for this will be discussed 
at more length after clinics 

Case 8. J. A. age twenty-four; farmer; had 



ioo THE EYE IN ITS 

suffered from epileptic seizures since sixteen 
years of age, which gradually increased in fre- 
quency until they were of daily occurrence; the 
mental faculties were very much impaired; the 
power of speech was affected to the extent that 
it was very difficult to understand the patient; the 
right upper and lower extremities were partially 
paralyzed, so that his walk consisted of a dragging, 
haltv gait, while the right hand and arm were 
used but little, and clumsily; constipated habit, 
and complexion pale. 

Vertical and horizontal diplopia disclosed no 
muscle defect; convergence was 45 deg. ; diver- 
gence 2 deg. After a careful examination lasting 
three days, I began repression with prism, base 
down, before the left eye, which, when forced to 
8 deg., led to an improvement in the color of the 
skin and the action of the heart, diminishing its 
activity from 95 to 75 beats per minute, with a 
feeling of warmth and tingling to the right hand 
and foot. Several tests were made by removing 
the prism and reversing its position, in which case 
the above symptoms were increased. From these 
indications, I now crowded the prism to 14 deg., 
base down, before the left eye. Twice I was 
obliged to reduce the prism 2 or 3 deg. to prevent 
diplopia, from the spasms that would ensue. The 
epileptic seizures were now reduced to one-third 
in number, also much in severity. I now made a 



RELATION TO HEALTH. 101 

complete division of the superior rectus muscle of 
the left eye. The cut eye assumed a normal 
position. The opposite eye turned upward 18 
deg. It required 12 deg. of prism to bring about 
fusion. I began reducing this, degree by degree, 
but the opposite eye was very slow and obstinate 
in getting back into line. At the end of six 
weeks, not having accomplished this, but still 
retaining single vision with prisms, I again exam- 
ined the lateral muscles with the same result as at 
first, 2 deg. of divergence and 45 deg. of conver- 
gence with this difference; vertical diplopia now 
indicated 5 deg. of convergence. I now added 
prism, base out, to correct this, and exceeded the 
correction by putting on the patient 24 deg. of 
prism, which were worn for three hours in my 
office, during which time the face became pale, 
the hand and foot cold, followed by a fit of con- 
siderable severity which lasted five minutes. This 
decided me that the present manifest convergence 
was due to spasm ; so, on the following day, I 
began repression at the near point, suspending 
accommodation with a fog, or +4D glass, and 20 
deg. of prism, base in, diverging the eyes. In 
two hours 4 deg. of prism, base in, could be tol- 
erated with single distant vision. I added a+iD 
glass reducing the distant vision to twenty-fiftieths. 
At the end of ten days the patient was wearing 
12 deg. of prism, base in; the vertical displace- 



102 THE EYE IN ITS 

ment that resulted from the operation had 
corrected itself; the eye had come down into line 
while I was diverging the eyes and repressing the 
reverse manifest defect in the lateral muscles. 
From this time on all conditions improved 
rapidly. The power of speech returned; no fits 
have occurred since, with the exception of occa- 
sional petit-mal. At the end of one month, 20 
deg., base in, were tolerated with single vision. I 
now advanced the internal rectus of the right eye. 
When last heard from, the patient had passed one 
year of perfect health, during which time the 
ciliary had been kept under a repression of a 
+2D glass for general purposes, with reading 
glasses +3D stronger. 

Had this patient abandoned treatment after 
the first operation, which I had to use persua- 
sion to prevent his doing, he undoubtedly would 
have suffered the inconvenience of double vision 
for a considerable length of time, as the result of 
a want of correction in the second defect. 

Case 9. Paralysis. Mr. E., aged sixty-five, 
passed an active business life up to sixty years of 
age, when he first began to experience restless 
nights with little sleep ; a growing irritability 
with occasional attacks of dizziness ; several 
months of each year were spent at health resorts 
and watering places with some little improvement 
at first ; but, on returning to business, the dis- 



RELATION TO HEALTH. 103 

turbed conditions would return after two or three 
weeks. For one year a dull pain was constant 
about the base of the brain. On January 15, 
1872, while sitting at breakfast, he was stricken 
with apoplexy and was unconscious for twenty- 
four hours. The next day on returning to con- 
ciousness, it was discovered that he had partially 
lost the power of speech and the use of the right 
upper and lower extremities. After three weeks 
he was able to limp about with the help of an as- 
sistant. The vertigo was excessive ; there was a 
constant dread of some impending evil ; the 
memory and reasoning faculties were much im- 
paired. With varying conditions of health, the 
paralysis still remaining, he visited me in 1892 
when his condition was rapidly growing worse. 
In this weakened and depressed condition, as is 
usually the case, the irregularities ,in the ocular 
apparatus were very manifest. A short under 
muscle in the right eye and inner muscle in the 
left were found, with one dioptre of manifest 
hyperopia. Repression in all three muscles was 
begun at once. At the end of the second day 
there was a marked change for the better ; the 
internal rectus now was detached. Immediately 
after this operation, the patient noted a percepti- 
ble improvement in the return of a natural feeling 
to the paralyzed side ; no inconvenience resulted; 
his speech was very much improved. The re- 



104 THE EYE IN ITS 

pression was continued, and in two weeks from 
this, he was wearing with perfect ease and single 
vision, 14 deg. of prism, base down, before the 
right eye. The impediment in the speech was 
now entirely gone, also the spells of dizziness ; 
the feeling of fright passed away, and in one 
month from the first, his visits were made without 
the necessity of having an attendant with him ; 
and were continued for the space of two months. 
From this time on, his circulation was good ; his 
bowels, which had been previously constipated, 
were now regular ; he acknowledged that he felt 
better than he had felt for ten years. During 
the space of over one year he has attended, with- 
out the slightest inconvenience, to whatever busi- 
ness he has had to do ; he eats and sleeps well, 
and says that he enjoys every moment of his 
life. 

Case 10. Consumption. In 1873, in company 
with my father and Dr. Goodrich, of Bellevue, 
Ohio, I visited Mrs. S. on a farm in Huron coun- 
ty ; she had suffered for a year and a half with 
consumption ; in the six months previous to my 
seeing her, she had had two hemorrhages ; the 
afternoon fever and night sweats had been very 
persistent for seven months. Little or nothing 
was hoped for in her case ; her principal treat- 
ment had been hypophosphites and cod liver oil, 
alternated each week with large doses of rich 



RELATION TO HEALTH. 105 

cream. Incidentally, during this visit, Mrs. S. 
asked if her left eye, which was very much 
turned inward, could be straightened. I told her 
I thought so, and a few days later it was operated 
upon. An over-correction of several degrees re- 
sulted from the operation ; of course this was not 
sought for, but it established a repressive strain. 
I paid two visits after the operation, after which I 
did not see the patient, as she moved to Hazelton, 
Pa. Two years passed, when one day the hus- 
band of Mrs. S. walked into my office. He 
talked with me some five minutes without refer- 
ring to his wife, who I felt confident was long 
since dead. He said, "You don't ask me about 
Mrs. S." I said, "I did not wish to distress 
you. I suppose she is no longer with you ?" He 
said "That's just where you are mistaken; she is 
perfectly well and hearty and weighs nearly two 
hundred pounds." He reported that a few 
months after I last saw her, her cough ceased 
and her health began rapidly to improve. This 
case was not operated on with the expectation of 
influencing the diseased condition of the lungs, 
but later experience has caused it to be recalled 
to my memory as a result possibly due to the 
radical change in the nerve-centers resulting from 
the repression established by the operation. 

Case 11. Woman; age twenty-two; consump- 
tion ; constipated habit ; complexion pale ; pulse 



106 THE EYE IN ITS 

85 in the morning, in the afternoon and evening 
120, with a hectic fever which had existed about 
ten months ; bright red spots about the size of a 
penny on both cheeks ; nights restless, and for the 
past six weeks night sweats were profuse ; lower 
lobe of left lung congested and dull on percus- 
sion ; cough quite severe ; no hemorrhage. Ex- 
amined this case in the morning; pulse 85. 
Repression was made with prisms by turning left 
eye up 12 deg. In thirty minutes the pulse was 
reduced to 64. To this prism was added ciliary 
repression reducing distant vision to twenty-fif- 
tieths. The next morning better conditions were 
reported for the previous afternoon and night ; 
pulse was now 76. Repression was now made at 
the near point by forcing the eyes outward 24 
deg., and fogging with a -[-5 D spherical. Patient 
looked at pictures in a book for half an hour ; 
had great difficulty to avoid going to sleep while 
sitting in the chair ; pulse reduced to 64 ; a 
healthy, red glow covered the entire face, ears 
and neck ; the hands and feet grew warm. Pa- 
tient now wore away + 3 D spherical, 14 deg. of 
prism, base down, before the left eye, combined 
with 18 deg., base in. Repression was being made 
in three directions. From this time on, there was 
no more hectic fever, flush, or night sweats ; at 
the end of two weeks from the first visit, the cough 
had entirely ceased ; the only symptom that 



RELATION TO HEALTH. 107 

remained was dullness on percussion of the lower 
lobe of the left lung. At the end of one month 
eight pounds had been gained. At this period a 
very serious interference with the treatment 
occurred. The patient's sister was taken ill. She 
watched by her bedside constantly for eight days, 
when the sister died. This, of course, told heav- 
ily against any further advancement in the case, 
but none of the old symptoms returned. On the 
day of the funeral, from over-exhaustion and 
grief, the nerve-centers were so disturbed, that I 
was obliged to reduce my prism 6 deg. in various 
directions to still maintain fusion. After she had 
had a few days' rest I increased the prism to its 
former standard. Two weeks after burying her 
sister, she was wearing 18 deg., base in. I now 
advanced the right internal muscle, leaving 10 
deg. of convergence, which in ten days had 
entirely disappeared. I now advanced the infe- 
rior rectus of the left eye, bringing it 6 deg. below 
its mate. A slight vertical diplopia existed after 
this operation, but in three weeks it had entirely 
disappeared. At the expiration of six months 
the patient had gained twelve pounds and her 
health in every way was perfect. 

Case 12. Male; age twenty- five ; acute con- 
sumption ; was constipated ; anaemic ; had cold 
hands and feet ; weight one hundred and nine 
pounds ; pulse 90 in the morning, in the evening 



io8 THE EYE IN ITS 

115; night sweats had been continuous for two 
months previous to the first visit ; a severe cough 
had existed for five months, and the expectoration 
was a thick mucus ; the sputa was not examined 
microscopically ; there had been no hemorrhages ; 
the left lung was dull on percussion and its breath- 
ing space limited, especially in the lower lobe. 
The diagnosis of consumption in this case was 
based on the evidence of the above symptoms 
without the microscopic examination of the sputa, 
the occurrence of a hemorrhage, or any apparent 
disintegration, but all of the other symptoms were 
well marked. 

The treatment consisted of repression of the 
ciliary with +5 D glasses, which were worn most 
of the time ; 2 D were permitted for outdoor pur- 
poses for limited periods. These gave but 
twenty one-hundredths of vision ; repression also 
of both external and left inferior rectus muscles. 
The complexion at once changed from a pale to 
a pink color ; the hands and feet were warmer. 
At the end of two weeks the patient was wearing 
16 deg. of prism, base down, before the left eye, 
which was repressing the innervation to the infe- 
rior rectus muscle. A division of the superior 
muscle of this eye was made at the end of two 
weeks. The cough ceased at once ; constipation 
was now relieved, and the heart's action reduced 
to 70. Repression in the ciliary and both exter- 



RELATION TO HEALTH. 109 

nals was continued with glasses for two weeks 
longer. I now made a complete division of the 
right internal and advanced the left external, by 
my operation of a single stitch and a ligature 
plate, thus bringing about 10 deg. of divergence 
by diffusion test. One month after the last oper- 
ation there still remained 3 deg. of divergence, 
while the vertical muscles were balanced. 

This case was heard from seven months after 
the last operation. The general health was much 
improved ; none of the old symptoms remained ; 
eighteen pounds in weight had been gained. 

Case 13 was the mother of the above patient, 
who accompanied him during his treatment ; her 
age was forty-four ; had suffered from chronic 
bronchitis for five years ; was of slight build ; 
ansemic ; had suffered much from headaches and 
spinal irritation ; had cold hands and feet ; pulse 
was normal. Ciliary repression was made with 
glasses that gave twenty-fiftieths of vision. Re- 
pression of the right inferior rectus was continued 
for one month, when she was wearing 22 deg. of 
prism, base down, before the right eye. Complete 
division of the tendon of the superior rectus was 
now made. The cough ceased the first day ; the 
hands and feet were warmer; the general circula- 
tion was much improved ; the headaches and 
spinal irritation were entirely relieved. This case 
was also heard from seven months after leaving, 



no THE EYE IN ITS 

when the health was reported good, with a gain 
of eleven pounds in weight. 

Case 14. Male; age forty-one; symptoms 
of consumption fourteen months ; pale, very 
nervous and restless ; occasional pains in left 
lung; lower and middle lobe dull; occasional 
night sweats ; hectic fever in the evening accom- 
panied by an excessive sensitiveness of the entire 
right side of the face, also of the cheek inside the 
mouth ; no inflammatory action existed in these 
parts ; cold water had to be drunk with great care 
to prevent its coming in contact with the right 
side of the mouth, in which case it gave rise to 
distressing pain ; right side of face could not be 
touched with a feather or even a hair without 
giving rise to great distress and alarm. This 
patient had been advised to have the facial 
nerves cut out to relieve the painful sensitiveness. 
The case yielded slowly to repression ; at the 
end of six weeks the left eye had turned upward 
15 deg. ; at this time +3 D glasses gave twenty- 
thirtieths of vision. I did not fog the vision to 
the same extent in this case, because I needed a 
higher acuity to assist in the repression in a ver- 
tical direction. There was some general im- 
provement in all the conditions of the patient up 
to this time. I now advanced the inferior rectus 
of the left eye, using my ligature plate, which 
drew it 6 deg. below its fellow by diffusion test, 



RELATION TO HEALTH. m 

but double vision did not result. The sensitive- 
ness in the face and inside of the cheek entirely 
disappeared within three days. Repression in 
the ciliary was now increased by fogging the pa- 
tient to twenty-sixtieths for distant vision, adding 
+ 3 D more for reading purposes, so as to sus- 
pend entirely the action of the ciliary for the 
time being ; the constipation was entirely relieved 
from this time ; the cough ceased, and in five 
months this patient had gained thirty pounds in 
weight ; pulse 70 ; appetite and complexion 
good. Perfectly good health continued for a lit- 
tle over one year, since which time I have not 
heard from the patient. 

Consumption. I have made preliminary ex- 
aminations and repression tests in one hundred 
and twelve cases of consumption, and in all with 
the exception of nine, some of which might have 
yielded by longer persistence in the tests, I was 
able to bring about marked changes in the prom- 
inent symptoms, generally consisting of a reduc- 
tion of the high action of the heart, change in 
the color of the skin, increase in the warmth of 
the hands and feet, where the extremities had 
been cold. None of these cases were treated 
further than a few preliminary tests. In such 
cases there is a great lack of .patience to under- 
go the repression ; but this is quite natural to 
nervous persons, inasmuch as they generally lack 



H2 THE EYE IN ITS 

confidence in the possibility to affect lung dis- 
eases through the visual centers. Consumption 
is most markedly a nervous disease. Its pre- 
monitory stage is marked by nervous conditions 
which, emphasized in character, accompany it 
through all its stages. F. J. McGillicuddy, A.M., 
M.D., of New York, says, "Tubercular consump- 
tion is not a local but a constitutional disease, 
and calls for general treatment. Tubercular 
bacilli do not and cannot cause consumption in a 
perfectly healthy individual. They only induce 
disease in persons with lowered vitality, who thus 
become susceptible to their influences." I am 
thoroughly convinced that a large percentage of 
consumption takes its origin from irritation aris- 
ing through the visual centers, and that many 
cases, especially in their earlier stages, are amen- 
able to treatment through the same medium. 

Case 15. Mr. F.; age sixty; delicate habit; 
constipated ; very nervous ; at the age of twenty 
was attacked with paralysis agitans, or shaking 
palsy, which lasted through a space of forty 
years. At the time I saw the patient his trouble 
was complicated with chronic bronchitis, sciatica 
and spasmodic stricture of the neck of the blad- 
der. Repression of the ciliary and inferior mus- 
cle of the right eye with glasses brought some 
alleviation of the shaking. A complete division 
of the superior rectus was made, after which, 



RELATION TO HEALTH. 113 

while my hand was still resting on the forehead, 
I noticed the shaking suddenly cease. The pa- 
tient turned pale, was nauseated. He said, "I 
feel strange ; I think my shaking is over." The 
spasm at the neck of the bladder also passed 
away at once, doing away with the necessity of 
using a catheter which had been required for the 
past three years in voiding the urine. I heard 
from this case occasionally for two years. The 
constipation, sciatica and chronic bronchitis were 
very much reduced, and there had not been any 
return of the shaking palsy or of the irritation of 
the bladder. 

Case 16. Gen. C. of the United States Vol- 
unteers; age sixty; dyspeptic; much depressed; in 
weak and rapidly failing condition; progressive 
atrophy of the optic nerves had gradually 
destroyed the vision, until barely enough sight 
was left to enable him to get about the streets; 
he could recognize friends only by the sound of 
the voice; could not read; would write from habit 
but could not see what he wrote; vision was so 
imperfect in this case that I could utilize but little 
fusion power in repression. It was three months 
before I arrived at a conclusion, at which time I 
made a complete division of the right internal 
rectus muscle. There was an immediate improve- 
ment in the general feelings, and in three months 
from this time the patient had gained twenty- 



H4 THE EYE IN ITS 

eight pounds in weight, and was able to read 
ordinary newspaper print, which I advised him to 
do sparingly. One year later distant vision was 
normal; general health and appearance were 
excellent. 

The following case that resulted fatally is 
evidence by no means adverse to the value of 
this treatment. The patient was in a very critical 
state at the time treatment was commenced, and 
the result verifies the sustaining or supporting 
power of repression during the time it was con- 
tinued. 

Case 17. H. H., age fifty; diabetes mellitus; 
gravity 1.048; quantity sixteen pints in twenty- 
four hours; intense thirst; very weak; unable to 
walk but a few rods; repression with prisms and 
by fogging vision to the possibility of reading 
ordinary type not farther than twelve inches, 
removed the thirst, and in three weeks reduced 
the specific gravity to 1.030 and the quantity to 
seven pints in twenty-four hours; heart's action 
was reduced from 100 to 75. These conditions 
were maintained with but little change for the 
space of three months, with the exception that the 
gravity occasionally fell to nearly normal, 1.022, 
and again went up to 1.030. The uncertainty of 
further results and the tediousness of the fogging 
process, were the cause of the patient's abandon- 
ing treatment at this point, removing the glasses 



RELATION TO HEALTH. 115 

and resorting to water cure treatment. A week 
after the glasses were discarded the bad symp- 
toms had all returned, and in three weeks the 
patient was dead. 

Case 18. H. H., girl; age ten; nervous, mis- 
chievous, playful child; after receiving slight 
chastisement from her teacher had a severe 
attack of St. Vitus's dance, which lasted for three 
months. This was followed by complete paraly- 
sis of the right side, and of the power of speech; 
the mental faculties became a perfect blank; the 
child's attention could not be attracted in any 
way, she would not even look up on being 
repeatedly called by her name; parents were 
obliged to feed her by putting food into her 
mouth. The left eye was partially blind; this 
was determined by covering the right, when the 
child would make an effort to uncover it; but she 
paid no attention when the left was covered. 
Under the influence of chloroform administered 
at three different times, a manifest defect in the 
superior and internal muscles of the left eye was 
very apparent. Under the existing conditions, I 
could only approximate the defects. A com- 
plete division of the internal rectus was made on 
this diagnosis. Plus 3D glasses for repressing 
any possible ciliary strain were tolerated by the 
child, but any stronger than these were rejected. 

In two months she was able to walk, consider- 



1 16 THE EYE IN ITS 

able impediment yet being noticeable in her 
speech, but her mental faculties were in every- 
way very much improved. In examinations of 
the eyes, she was now able to answer questions. 
Repression was commenced by forcing the left 
eye upward with prism. More improvement in 
the use of the paralyzed extremities was noticed. 
A division of the superior rectus of this eye 
was made. In four weeks from this time, the 
child was able to walk with a somewhat halting 
gait, and use the right hand. In eight months 
from the time I first saw the patient, not a trace of 
the difficulty was left. The child was now witty, 
intelligent, active, and desired to return to 
school. I advised her not to do so. After 
a lapse of two years I saw this little patient 
again, and in perfect health which had continued 
since the treatment. Two years later, making in 
in all four, I received a letter from her father 
stating that her general conditions of health were 
excellent. 

Case 19. Male; age thirty-five; was a bright 
and promising youth, quick to learn and more 
than ordinarily ambitious. He was eccentric, his 
disposition and habit being so changed at times 
that they might belong to another person. At 
the age of twenty-five, he was actively engaged 
in a successful business, and from this time these 
changes of disposition grew gradually more 



RELATION TO HEALTH. 117 

marked. His choice of friends and associates 
was usually fastidious ; but every three or four 
months a period of two or three weeks would in- 
tervene, in which all his leisure hours would be 
spent in neighborhoods strange to his former as- 
sociations, and among people of the coarsest type. 
These periodical changes of disposition and asso- 
ciation were as marked and regular as the sprees 
of a periodic drunkard. Through a general in- 
creasing nervous debility he, at the age of thirty- 
two, was thoroughly incapacitated for work, and 
the business passed into the hands of another 
member of the family. He was now unable to 
carry on a coherent correspondence. His mem- 
ory was very much impaired ; he was unable to 
fasten his mind upon either book or newspaper ; 
and, if he tried, a moment afterwards forgot what- 
ever he may have read. At times he was morose 
and surly, and would be dangerous to cross. 
Again, being very sympathetic, he would break 
down in a child-like way, and from some imagin- 
ary cause would be moved to tears. Again his 
ambitious side would return and he would specu- 
late in ridiculously impossible schemes. Through 
incompatibility his wife now deserted him ; con- 
sequently his disturbed mental symptoms were 
rapidly and greatly emphasized, and at the age of 
thirty-three he was placed in an asylum. From 
this time his scheming and eccentric ambitions 



n8 THE EYE IN ITS 

ceased. For the next two years despondency 
was the marked feature of his condition, occa- 
sionally alternated by spells of pitiful repining 
and regret. 

It was in this condition that he was brought 
to me by his mother. The only notable local 
symptoms were a pale complexion and a heart's 
action of 96. It required fully an hour of care- 
ful handling on my part before I gained his 
confidence and secured his attention sufficiently 
to proceed with an examination ; but he gradually 
grew very much interested, and was no longer 
disposed to interfere with my tests. Refraction 
in both eyes at the far point was above normal, 
twenty-fifteenths. It was perfect at the near 
point. By diffusion test, far point, prism base 
down before the left eye, the upper dot or light 
was 2 deg. to the left. With prism base in the 
left light was the lower, manifesting a left hyper- 
phoria of y 2 deg. in conjunction with a manifest 
esophoria of 2 deg. at the far and near points. 
Two degrees, base down, before either eye created 
diplopia. Could fuse 1 deg. before either eye, but 
with my vertical chart, using a 2 deg. prism, base 
down, before the left, there were two dots 2 deg. 
apart, while 2 deg., base down, before the right 
separated the dots or lights 1 y 2 deg. from each 
other. I now placed before his right eye 1 deg. 
of prism, base down. After a few minutes vision 



RELATION TO HEALTH. 119 

seemed sharper. This was shortly increased to 2 
deg., and within half an hour to 3 deg. Pulse 
was not materially changed. Even with repeated 
efforts the next half hour I failed to increase the 
prism. The countenance was somewhat flushed 
and a violent headache followed, which was some- 
thing from which he had never suffered before. 
The prisms were removed and tests continued the 
following day. The next day I commenced with 
1 deg., base down, before the left, the reverse of 
the previous day's treatment. In an hour he had 
accepted 5 degs. of prism in this direction, the 
complexion was paler and the heart's action had 
mounted to 124, with an increase of nervous 
symptoms. I now changed the position of the 
prisms to the same that it had been during the 
first day's test, base down before the right eye. 
In another half hour he was able to fuse for 4 
deg. of prism. The pulse was reduced to 86, and 
the skin became somewhat flushed. Headache 
again returned and the test was abandoned for 
the day. 

As to symptoms, base down before the right 
diminished somewhat the excitability of the 
heart and improved the color of the skin, while 
at the same time it brought on severe headache. 
With prism in the opposite direction the heart's 
excitability was much increased, the complexion 
paler, and the nervousness visibly aggravated. 



120 THE EYE IN ITS 

On the following day I chose that position 
which improved the heart's action and the color 
of the skin. Four degrees, base down, before the 
right was all he could fuse under. He was 
allowed to wear this home the remainder of the 
day. His night's rest was slightly improved. 
During the next test, he was able to fuse for 6 
deg. of prism. The glasses were comfortable 
during the day, and the vision remained single 
until just before bedtime, when headache again set 
in. On awaking in the morning, he was unable 
to fuse for his 6 deg. of prism, and after having 
spent a restless night he returned to my office 
without the glasses. His eyes now manifested 
the reverse of every previous condition ; the right 
eye appeared to be the lower of the two. This I 
suspected to be due to spasm, owing to a bad 
night's rest. I proceeded, degree by degree, to 
coax the eyes to fuse under prism, base down, 
before the right. I was unable to succeed with 
more than 3 deg., which I left on the patient. 

On awaking in the morning he was able to fuse 
for the 3 deg., and came to my office wearing the 
glasses. He now succeeded in fusing for 7 deg. 
early in the morning. He wore the prisms all 
day with comfort and some little improvement in 
feelings, his heart's action being reduced to 80. 

On the following morning his eyes would not 
fuse for 7 deg., but by my orders he kept the 



RELATION TO HEALTH. 121 

glasses on until he arrived at the office. I did 
not remove them, but suspended the ciliary accom- 
modation with a +3 D spherical glass. Fusion 
at the near point took place at once. After read- 
ing a short time and having the sphericals 
removed, he was able to fuse for all distances. 
These glasses were continued during the day. 
The night's rest was much improved. When he 
put on the glasses after awaking in the morning 
vision was double, but after half an hour fusion 
had taken place. Complexion was decidedly bet- 
ter and the heart's action the same, 80. At pres- 
ent, prism could not be increased above 7 deg. 
I now suspended accommodation with +3 D 
spherical glasses, and at the near point was able 
to increase my prism 3 deg. more. After he had 
looked at pictures for half an hour, the pulse was 
reduced to 76, and the face was quite flushed, 
with some little nausea. The following day the 
same was repeated without the nausea. I now 
increased the glasses to -f 5 D. Buzzing in the 
ears shortly followed this, dizziness, nausea and 
profuse perspiration ; pulse reduced to 70. I now 
suspected that the ciliary had suddenly relaxed 
its tonic innervation and on examination, found 
his vision normal with a +1-50 spherical glass in 
connection with the 7 deg. of prism, base down, 
before the right eye. He now manifested 3 deg. 
of exophoria, instead of 2 deg. of esophoria which 



122 THE EYE IN ITS 

had showed on the first examination. At the near 
point the exophoria was 18 deg., whereas the first 
examination gave 2 deg. in the opposite direction. 
The correlation that had existed under abnormal 
conditions was now practically broken down, and 
a partial manifestation of the actual state of 
the muscles presented itself. Plus 2 D spherical 
glasses and 7 deg. prisms were worn until bed 
time, which was an hour earlier than usual, and 
he slept ten continuous hours, the longest period 
of rest that he could remember for many years. 
On the following morning his eyes accepted the 
7 deg. of prism but rejected the spherical glasses ; 
everything seeming exceedingly foggy and dim 
through them. The ciliary spasm had returned. 
The long night's rest had recuperated the nerve- 
centers, and they refused to yield to the same 
conditions that had controlled them on the pre- 
vious day. I now increased to 10 deg. of prism, 
base down, before the right, a -f 5 D spherical, 
and 18 deg. of prism, base in, because of the fact 
that, in the relaxed condition of the previous day, 
he had manifested this amount of exophoria at 
the near point. Under this combination, even at 
the near point, some considerable difficulty was 
experienced in inducing the eyes to fuse. After 
they had fused, reading was continued for half an 
hour, when the nausea and profuse perspiration 
again set in. The patient was induced to tolerate 



RELATION TO HEALTH. 123 

the glasses and these discomforts for half an hour 
longer, when the pulse had fallen to 62. The 
patient now returned home with three pairs of 
glasses, 7 deg., base down, before the right eye, 
18 deg., base in, with +2 D spherical glasses. 
Nine hours of continuous sleep followed. In the 
morning his eyes fused under the 7 deg., base 
down, but again rejected both other pairs. It 
would be needless to detail this case further. 
The process of discovering the abnormal innerva- 
tions that had maintained a perfect correlation in 
the action of the two eyes, had now revealed the 
defects, while the mental condition of the patient 
showed marked signs of improvement. Changes 
in the manifestation of the eye defects continued 
from day to day to reveal and again hide them- 
selves until, at the end of one month, the patient 
was wearing before the right eye 20 deg. of 
prism, base down, and 20 deg. of prism, base in. I 
now made a complete detachment of the superior 
tendon of the right eye, dropping the eye 6 deg. be- 
low its mate. At this time I had the patient wear- 
ing 20 deg. of prism, base in, with +2.50 spherical 
glasses, which gave normal vision. The complexion 
from now remained good, and the pulse was 
never found above 72. Two weeks after the first 
operation the left external tendon was completely 
detached, producing 8 deg. of esophoria by diffu- 
sion test, but lights fused without prism. Repres- 



124 THE EYE IN ITS 

sion with prisms, base in, was continued for three 
weeks, when 16 deg. could again be tolerated 
without double vision. I now completely detached 
the external tendon of the right eye. Under 
diffusion test, there were now 16 deg. of conver- 
gence and an inability to maintain single vision 
farther than fifteen inches. Plus 2.50 D spheri- 
cals were continued with 6 deg. of prism, base 
out, to bring about fusion for distance. This was 
reduced slowly from day to day and, in three 
months from the last operation, no double vision 
existed. 

The patient's mental condition was now en- 
tirely relieved. He seemed happy, would smile, 
laugh at anything funny, and seemed fond of tell- 
ing witty anecdotes. The only abnormal condi- 
tion that now existed was that, on looking to the 
extreme right or left, double vision would occur. 
I deemed it advisable to keep the distance vision 
at twenty-fortieths, thus continuing a slight ciliary 
repression. 

I have occasionally seen this patient during the 
space of two years. His mental condition has 
continued very satisfactory ; none of the eccen- 
tricities of his earlier life have recurred ; his whole 
character seems changed ; he is of a quiet, happy 
disposition, and attends to whatever business he 
has to do without worry. 

One year after the first operation a perfect 



RELATION TO HEALTH. 125 

balance existed in all ocular muscles under diffu- 
sion tests. He fused for 4 deg. of prism, base 
down, before either eye, 6 deg., base in, and 45 
deg., base out. A new and perfect correlation 
had been established. 

Case 20. Mrs. H., Joliet, 111. This patient 
was brought to my office by Dr. Orin W. Moon, of 
Lockport, 111. She says she has suffered for the 
past ten years from female weakness consisting of 
chronic inflammation and neuralgia of the ovaries; 
severe headache preceding and through the 
menstrual period; has always been of a delicate 
habit; catarrh of the throat, eustachian tube and 
internal ear has been increasing for the past ten 
years with a gradual loss of hearing; for the past 
two years the right ear has been totally deaf 
while the left could distinguish loud conversation 
only at a close distance. Has taken various 
remedies almost continuously for the past ten 
years. The catarrhal difficulty and deafness 
were treated locally, the treatment including 
dilatation with the Pulitzer bag and catheter. 

Vertical muscles apparently balanced; 5 deg. 
of convergence at the far point; esophoria at the 
near point, thirteen inches; at the start I fortun- 
ately suspected this to be a case of reverse 
manifestation. I suspended ciliary strain with a 
+ 5D glass, and with 30 deg. of prism, base in, 
found that the patient could fuse at the near 



126 THE EYE IN ITS 

point. I directed her to read in the above com- 
bination, and in ten minutes she could hear a faint 
whisper in the left ear and ordinary conversation 
in the right. By repression I developed exo- 
phoria of 20 deg. at the far point, and on the 
fourth day made a complete division of the ten- 
don of the external rectus of the left eye. All of 
the previous disturbances were at once relieved; 
within one month the catarrh had disappeared; 
all sensitiveness and neuralgia in the ovaries were 
now gone, and for the first time in her life the 
monthly sickness came and passed without the 
slightest headache or local disturbance. In 
every way the general health has been much 
improved and the patient says she feels perfectly 
well. 

I do not present this case as an ordinary one, 
but because it is one of the quickest and most 
remarkable cures in the history of my practice. 

The following tabulated list of clinics has been 
selected from a large number of cases for the 
express purpose of showing what class of cases have 
yielded and may possibly yield to repression 
treatment. Failures in about the proportion 
noted in the preceding detailed clinics could be 
shown. A report of adverse results would be of 
no value as it is the object of this work to show 
what can be accomplished through the visual 
centers. The failures are due to several causes, 



RELATION TO HEALTH. 



127 



especially neglect to follow treatment, and to the 
fact that some cases are beyond or outside of its 
influence 





a w 








PERIOD 






H 












DISEASE. 


K 2 

s 


TION. 


SEX. 


AGE 


TREAT- 
MENT. 


RESULT. 


Ovaritis with general fe- 














male weakness 


M. 


5yrs. 


F. 


38 


3mos. 


Cured. 


Prostatitis with inflamma- 














tion of the neck of the 














bladder 


M. 


12 " 


M. 


58 


r mo. 


Cured. 


Insanity 


M. 


5" 


M. 


5° 


8 mos. 


Cured. 


Uric Acid Diathesis, rheu- 














matism and general ner- 














vous debility - _ - - - 


M. 


8 " 


F. 


S3 


2 mos. 


Cured. 


Chronic Rheumatism 


s. 


10 " 


M. 


48 


4 mos. 


Very much re- 
lieved. 


Asthma 


s. 


20 " 


F. 


Si 


1 mo. 


Cured. 


Insanity 


M. 


5 " 


F. 


3 2 


7 mos. 


Cured. 


Diabetes Mellitus - - 


S. 


4" 


M. 


40 


1 y- 


Cured. 


Paralysis hemiplegia - - 


M. 


12 " 


M. 


SS 


1 yr- 


Cured. 


Motor Ataxy - - - - 


S. 


3 " 


M. 


38 


5 mos. 


Much improved. 


Prostatitis and irritation of 














the bladder - - - - 


S. 


12 " 


M. 


5° 


5 mos. 


Cured. 


Rheumatism - 


M. 


8 " 


F. 


55 


6 mos. 


Cured. 


Consumption -_ - - - 


S. 


1 " 


F. 


22 


8 mos. 


Cured. 


Consumption with ner- 
vous debility - - - 














S. 


IS" 


M. 


25 


8 mos. 


Cured. 


Ovaritis ------ 


M. 




F. 


26 


3 mos. 


Cured ; was pre- 
viously barren ; 
had a healthy 
babe 1 yr. after 
treatment 


Hay Fever - - - - 


M. 


10 " 


M. 


34 


3 mos. 


Cured. 


Heart disease functional. 


S. 


5 " 


F. 


16 


3 mos. 


Cured. 


Glaucoma 


M. 


5" 


M. 


S3 


4 mos. 


Cured; one eye 
was blind at 
beginning of 
treatment. 


Nystagmus - - - - 


S. 


20 " 


M. 


28 


1 mo. 


Cured. 


Heart disease functional - 


S. 


3 " 


F. 


22 


6 wks. 


Cured. 


Prostatitis - - - - 


M. 


20 " 


M. 


6S 


1 mo. 


Cured. 


Rheumatism^ - - - - 


M. 


IS " 


F. 


58 


1 y- 


Cured. 


Diabetes insipidus - - 


M. 


3" 


F. 


37 


8 mos. 


Cured; was pre- 
viously barren : 
gave birth to a 
healthy babe r8 
months after 
treatment. 


Ataxy 


S. 


1 " 


M. 


3 2 


3 mos. 


Much improved. 


BrighVs disease - - - 


S. 


2 " 


F. 


40 


4 mos. 


Cured. 


Ovaritis ------ 


M. 


6" 


F. 


30 


2 mos. 


Cured, previously 
barren ;i8 mos. 
after treatment 
gave birth to a 
healthy babe. 















I2S 



THE EYE IN ITS 







D U 
W J 








PERIOD 




DISEASE. 




5 u 
< "> 


DURA- 
TION. 


SEX. 


AGE 


OF 
TREAT- 
lt CNT. 


RESULT. 


Anaemia and general ner- 














vous debility - 




M. 


10 yrs. 


F. 


32 


4 mos. 


Cured ; previous- 
ly barren; had 
babe 10 mos. 
aftei treatment. 


Insane and paraly 


zed - - 


S. 


6 mo. 


F. 


II 


9 mos. 


Cured. 


Prostatitis and irritation of 














the bladder - - 




M. 


ioyrs. 


M. 


68 


1 mo. 


Cured. 


Cirrhosis of the liver - 


M. 


12 " 


M. 


45 


4 mos. 


Cured, has re- 
















mained per- 
















fectly well for 
















two years. 


Melancholia and 


sterility 


M. 


8" 


F. 


37 


1 yr. 


Cured; gave 
birth to babe 
10 months after 
treatment. 


Constipation and 


nervous 


















S. 


12 " 


M. 


27 


6 mos. 


Cured. 










M. 


8 " 


F. 


5* 


9 mos. 


Cured. 


insanity - 








S. 
M. 




F. 
M. 




3 wks. 
9 mos. 


Cured. 
Cured. 


v_norea ... 
Diabetes mellitus 




I " 


49 


Shaking Palsy - 




M. 


IO " 


M. 


60 


1 mo. 


Cured. 


Rheumatism, chronic - 


M. 


9" 


F. 


63 


7 mos. 


Cured. 


Melancholia, 


constant 


















S. 


6" 


M. 


41 


6 mos. 


Cured. 






Diabetes mellitus 




M. 


i " 


M. 


49 


9 mos. 


Cured. 


Shaking Palsy - 




M. 


io " 


M. 


60 




Cured. 


Rheumatism, chr 


)nic - - 


M. 


9 " 


F. 


63 


7 mos. 


Cured. 


Melancholia, 


constant 


















S. 


6" 


M. 


4i 


6 mos. 


Cured. 










S. 


12 " 


F. 


28 


2 mos. 


Cured. 


^vstnma - - - 




Prostatitis - - 




M. 


9 " 


M. 


50 


6 mos. 


Cured. 


Ovaritis, sterility 




M. 


9" 


F. 


26 


5 mos. 


Cured; had heal- 
thy babe 9 
mos.aftertreat- 


Chronic ulcerative 


catarrh 


M. 


6" 


F. 


43 


8 mos. 


Cured ; had been 
pronounced and 
treated as syph- 
ilitic catarrh. 


Hay fever - - 




M. 


12 " 


F. 


36 


1 mo. 


Cured. 


Motor Ataxy 




S. 


s" 


M. 


45 


4 mos. 


Much improved 
in every way. 


Constipation and 


dyspep- 


















M. 


So" 


F. 


72 


2 mos. 


Cured. 






Sciatica and uric acid 


















M. 

S. 




M. 
M. 


65 
51 


6 mos. 
3 mos. 


Cured. 
Cured. 


Hay fever - 




15 
6" 


Consumption 




M. 


18 mo. 


M. 


45 


7 mos. 


Cured. 


Diabetes insipidus - 


M. 


2 " 


M. 


43 


1 mo. 


Cured. 


Shaking Palsy - 




S. 


5 " 


M. 


6S 


3 mos. 


Cured. 



RELATION TO HEALTH. 



VIII. 

"\ X 7HEN the optic axes deviate or have a 
* » tendency so to do, the fault has com- 
monly been attributed to muscular weakness 
or paresis. If the left eye deviated above its 
mate, this theory assumed that the inferior mus- 
cle of that eye was insufficient in strength to 
hold it down. If it deviated inward, the outer 
muscle was said to be too weak ; if outward, the 
inner muscle was too weak. This reasoning nat- 
urally assumes that to maintain a balance, there 
is a constant contention in the various eye mus- 
cles, and whenever a muscle becomes weaker than 
its fellow, there will be a deviation in a direction 
opposite to the weak one. That this can hardly 
be true is evident from the fact that the internal 
rectus is known to have generally fully five or 
six times the strength of its opposite, the exter- 
nal rectus ; and if it were a relative difference in 
strength of the muscles that caused the eyes to 
deviate, all eyes having muscles of such compar- 
ative strength would be constantly turned in to- 
ward each other. The fact is, it is not a question 
as to the relative strength of the muscles. Nor- 
mal eyes should, under absolute relaxation of all 
9 



130 THE EYE IN ITS 

the muscles, be in a perfectly parallel plane for 
an infinite distance ; although some muscle might 
be weak, an eye would present perfect balance 
with absolute relaxation of the muscle opposite 
the weak one. When the optic axes are not 

PARALLEL, THE CONDITION IS DUE TO ONE OF TWO 
CAUSES EITHER AN ANATOMICALLY SHORT MUSCLE, 

or one contracted by spasm. This rule does 
not hold in paralysis, which can not be 
determined by a relative position of the optic 
axes alone, but by individual movements of one 
eye. Neither are the tendencies to relative devi- 
ation generally due to paresis, a term sometimes 
used in lieu of muscular asthenopia. 

The almost universal deviation of the eyes of 
the dead, the blind, the new born babe ; of those 
who have been rendered unconscious by the use 
of anaesthetics, alcohol or narcotic poisons ; and 
of those who are in a state of suspended anima- 
tion from other causes, such as fainting, apo- 
plexy, or coma, is due to a suspension of inner- 
vation more or less complete, during which the 
eyes fall into those positions in which the ana- 
tomical length of the muscles would naturally 
hold them. Deviations under the above condi- 
tions are certainly not due to paresis or muscular 
weakness. True, we do have weak muscles, but 
they are generally on the side of the eye oppo- 
site to that in which the theory of muscular as- 



RELATION TO HEALTH. 13 1 

thenopia would have them. For instance ; 
when the deviation of an eye is due to a short 
external muscle, tending to draw the eye out- 
ward, it is the external muscle which is really in- 
sufficient, asthenopic, or undeveloped, for never 
has it had normal action. It has always been 
drawn upon and stretched by the opposite mus- 
cle, in the effort of the latter to pull the eyes 
into line. In such cases, gymnastic exercise of 
the ocular muscle in which there is a manifest 
deviation will sometimes restore the physical bal- 
ance, but it does so by making the defect latent 
again. It does its work by once more increasing 
the already excessive innervation to a hiding 
standard. For the muscle that we increase in 
strength by gymnastic exercise, is the over-de- 
veloped one. This exercise simply stretches the 
short muscle more, and increases the abnormal 
innervation in the strong one ; hence the results 
of these gymnastics are the opposite of what we 
should seek to obtain. Such exercise will often 
restore a balance of the optic axes, but it does so 
at the expense of the nerve-centers. 

In that class of cases where there is a mani- 
fest deviation of the optic axes, and where such 
deviation is due to a spasm, which usually turns 
the eye in a direction opposite the short muscle, 
gymnastic exercise will bring some relief, for it 
represses in a small measure the abnormal inner- 



132 THE EYE IN ITS 

vation, as it brings the eyes back into line. This 
relief might possibly be increased by crossing the 
line of balance and forcing the eyes in the oppo- 
site direction to a considerable extent by repres- 
sion. 

There is always a physical comfort in seeing 
easily, but the disturbances arising from eye- 
strains are not always local ; they do not always 
affect the vision. 

Whenever the shortness of a muscle begins 
to manifest itself, we may infer that the nerve- 
centers have wearied of holding the eyes in 
place and begin to suspend their labor. There 
is an effort of the nerve-centers to rest from an 
over-taxed condition, and we should always aid 
them as much as possible in this effort. This is 
done by placing prisms before the eye in the 
direction opposite to that prescribed in gymnas- 
tic exercise, increasing our prism in this direction 
as long as fusion will take place. We establish a 
repressive strain in the opposite direction ; that 
is, a strain in which there is an effort to suspend 
nerve-impulse which has become excessive and 
more or less fixed in the muscle opposite the 
short one. 

By exercising this repressive strain for a few 
weeks or even months, we cannot expect to sus- 
pend absolutely and entirely an abnormal nerve- 
impulse that has required many years to attain its 



RELATION TO HEALTH. 133 

present intensity. We should reasonably expect 
long periods of time to be necessary to repress 
these brain leaks that have been established since 
birth. 

A tendency to deviation of a given number of 
degrees, say 6, will give rise to varying amounts of 
strain in different individuals ; for, although by 
reason of the shortness the eyes tend to deviate 
6 deg. in each case, the innervation that brings 
the eye back into line will vary in accordance 
with the size, strength and elasticity of the short 
muscle. A thin, weak muscle causing the axes 
of the eyes to deviate 6 deg., would require a 
certain amount of motive-force to correct the 
defect, whereas, a broad, tendonous, inelastic 
muscle that turned the eye 6 deg. would require 
much more motive-force to bring it into place. 

So, THE NUMBER OF DEGREES OF DEVIATION IN THE 
OPTIC AXES CAN NEVER DETERMINE THE AMOUNT OF 
EYE-STRAIN. 

It has often been observed that considerable 
manifest eye-strain may exist without materially 
inconveniencing the patient, or without inducing 
any noticeable nervous disturbance. From the 
fact that much smaller defects have apparently 
been the cause of excessive nervous disturbance, 
the conclusion drawn by some has been that 
these muscular defects are not responsible for the 
physical conditions co-existent with them. This 



134 THE EYE IN ITS 

is erroneous and based on superficial investigation. 
A high degree of manifest defect, say 20 deg., 
may exist as in the case No. I ; but there is a great 
deal of the time during which the eyes are at 
rest in manifest troubles. Many times during the 
day, and always during sleep, there is no effort of 
the nerve-centers to parallelize the optic axes. 
The same amount of anatomical defect that we 
have just supposed may exist in a case where it is 
entirely latent. In this case the innervation that 
sustains parallelism is constant and fixed, and 
the strain is continuous. It is a constant source 
of nerve-center drain and irritation. Even during 
the hours of sleep the spasm continues, as in latent 
hyperopia. Otherwise, we should find, on waking 
a person from sleep, that the spasm of latent 
hyperopia had ceased ; but such is not the case. 
The same character of tonic spasm may exist in 
any of the long muscles as well as in the ciliary. 
The more manifest a muscular defect is, 
the less will be the strain and disturbance 
of the nerve-centers, for this form has 
periods of rest \ but no periods of rest ever 
come, even during sleep, to nerve-centers 
that are sustaining absolutely latent eye- 
STRAIN. The highest state of nervous dis- 
turbance EXISTS WHERE THE DEFECTS ARE 
ABSOLUTELY LATENT, OR THEIR MANIFESTATION 
REVERSED. 



RELATION TO HEALTH. 135 

The power of the eyes to fuse or overcome 
prisms held in various directions before the eyes, 
is much higher at the near point than at a dis- 
tance. At twenty feet it may be difficult to fuse 
2 deg. or 3 deg. of prism, whereas 6 deg., 8 deg. 
or io deg. may be fused in the same direction at 
a distance of ten or twelve inches. Cases will 
vary considerably, and no general rule can be 
laid down, but fusion power is always much higher 
at the near point. It is the high fusion power of 
the near point that I often find very useful in 
treatment. Fusion power is proportionately high- 
er under a bright light, or one of high candle 
power, than under a weaker one. A plurality of 
objects, non-similarity of shape, variety of color 
and irregularity of arrangement, emphasize the 
fusion stimulus ; on the other hand, any imperfec- 
tion in the refractive media of the eye would dim 
or lessen the acuity of vision and the fusion 
power. A plain, blank surface offers no stimulus 
for fusion ; a single point offers the least. 

In utilizing fusion power to establish repress- 
ive strain, these conditions should be always kept 
in mind ; acuity of vision, density of light, num- 
ber of objects, and distance. 

In testing with prisms, there is sometimes an 
objection to using a light. The field of vision is 
so sensitive in some eyes that the faint, doubly 
refracted image from the two faces of the prism 



13 6 THE EYE IN ITS 

impresses itself on the retina of the patient, and 
this is mistaken for the second image of diplopia, 
which it is not. It is difficult, for this reason, to 
tell whether actual fusion has taken place. Con- 
sequently, in testing with prisms, it is safer to use 
some non-illuminated object to look at ; but a 
light will be the most practical where the vision 
is foggy after an operation, or from other causes. 

Again, when we think we have obtained fusion, 
great care should be taken to make ourselves sure 
that the two images are not so far separated from 
each other that one is thrown out of the field of 
vision, or so far into it as to cause it to be sup- 
pressed and only one object to appear. This pre- 
caution should always be taken. 

An eye, to accommodate itself to a prism, 
always turns towards its apex. For this reason, 
in seeking to relieve and reverse the strain of a 
short muscle or to establish a repressive strain 
with prisms, we should always point the apex 
toward the short muscle. 



RELATION TO HEALTH. 137 



IX. 



ABNORMAL innervation of the ciliary muscle 
is very common. This muscle, surround- 
ing the crystalline lens, exactly as the metal rim 
surrounds a spectacle, possesses the power to con- 
tract itself around the lens, thus increasing its 
antero-posterior convexities, and thereby raising 
its magnifying power, whenever that is deficient. 
This defect in the lens constitutes hypermetro- 
pia — or shorter, hyperopia — a condition in which 
the rays of light are brought to a focus behind the 
retina, or would be if there were a suspension of 
innervation. A stimulus for perfect vision, or a 
clearly defined impression in the visual centers of 
the brain, is awakened by the imperfect picture, 
and the impulse is sent through the ciliary nerves 
to the muscle, thus causing it to contract, so that 
the magnifying power of this little glass brings 
the rays of light to a perfect focus, producing a 
clearly defined image on the retina. The impact 
here sends impulses to the visual nerve-centers, 
giving rise to the feeling of perfect sight, which 
is the most instructive and the most continuously 
enjoyable of all our senses. If the crystalline 
lens possessed just the proper curvatures to bring 



13 s THE EYE IN ITS 

about perfect refraction at an infinite distance 
without any effort on the part of the ciliary mus- 
cle, it would still require an effort of this muscle 
to increase the refractive power for all nearer dis- 
tances than twenty feet. This is called accom- 
modation. Such an eye would be natural or 
emmetropic. 

When imperfect vision is due to a deficiency 
of refraction in the crystalline lens, say 2 D, or 
when an eye whose vision is practically perfect 
will accept a 2 D spherical lens without impair- 
ment of vision, we have what is termed manifest 
hypermetropia to the extent of 2 D. We might 
well discriminate between these two forms of 
manifest hyperopia, naming the first Non-func- 
tional Manifest, and the second Functional Mani- 
fest Hyperopia, for the reason that in the first 
form, the function of vision is not perfectly per- 
formed, while in the latter it is. By using some 
drug to suspend the action of the ciliary, such as 
atropine, hyoscyamine, and their congeners, we 
may perhaps find that the same patient cannot see 
well with the 2 D glasses, but now requires 4 D, 
under its influence, to bring about the best possi- 
ble vision. Without the drug, we had 2 D of 
deficiency of refraction; with it, 4 D. The 2 D 
is called manifest, the extra 2 D developed under 
the drug is called latent hypermetropia. It has 
been the aim of the profession always to deter- 



RELATION TO HEALTH. 139 

mine the full amount of latent hyperopia. The 
advice given in all text books has been to put on 
the strongest convex glasses with which the 
patient could make out twenty-twentieths of 
vision, also the weakest concave glasses, thus 
recognizing the fact that it is always advisable to 
suspend as much ciliary strain as possible. This 
idea is not new, it is a time-honored method in all 
text books of the past as well as the present. 
The fact that mydriatics in some cases are variable 
in their action on the same patient at different 
times and under various conditions of health, is 
known to every oculist. 

Latent hyperopia may exist to a high degree 
and yet be undiscoverable by the use of mydri- 
atics. In many cases where mydriatics fail, fog- 
ging will reveal a high state of hyperopia. This 
relaxation of the ciliary by repression is often 
temporarily much enhanced by the administration 
of lobelia, wine of antimony, ipecac and similar 
general systemic depressants of the nervous sys- 
tem. Conversely, repression is retarded by stim- 
ulants. 

In some cases of hypermetropia, hyoscyamine 
and atropine act, at different times, quite uniformly 
in discovering various amounts of deficient refrac- 
tion ; in others, their action is uncertain and vari- 
able to a considerable extent ; while in some 
cases, these drugs have failed to give the slight- 



14° THE EYE IN ITS 

est evidence of hypermetropia, which has been 
revealed afterwards by the process of fogging. 

As in case No. 2, page 81, a two grain solution 
of atropine was dropped into the eyes twice a day 
for one week, as a test for hyperopia, but no 
hyperopia was developed. The solution was 
increased in strength to four grains to the ounce 
and continued for three days. The constitutional 
effect of the drug was so prominent, that I was 
obliged to discontinue it at this time. On exam- 
ining the eyes, I again found no indication of 
hypermetropia. Vision without the glasses was 
twenty-twentieths or normal. I prescribed a 4-1 
D glass for outdoor use, which gave twenty-fif- 
tieths of vision at twenty feet. For house, read- 
ing, writing, and all close purposes, I prescribed a 
-\-4 D, which was I D more than an absolute sus- 
pension of the accommodation at thirteen inches. 
This rendered the patient artificially myopic. At 
the expiration of three months, through the +i 
D glasses at twenty feet, vision was twenty-twen- 
tieths, and though the glasses were removed, 
vision continued normal, but when they were 
returned to the eyes, the vision through the 
glasses was reduced to twenty-thirtieths, and 
required about half an hour to regain its normal 
condition. I now increased the power of both 
pairs of glasses .75 of a dioptre, which again gave 
twenty-fiftieths of vision for objects at a distance, 



RELATION TO HEALTH. 141 

and for objects at twelve inches the same amount 
of artificial myopia that the first pair of reading 
glasses gave. At the expiration of six months 
more, vision under the 1.75 D, at twenty feet, was 
normal. On removing these glasses, some five min- 
utes were now required for normal vision to take 
place, indicating that the reduction of ciliary in- 
nervation was becoming somewhat fixed. The 
glasses were continued as well as the above 
modus operandi for a period of three years, since 
which time the patient has been wearing + 2.75 
for all general purposes. With these glasses 
vision is twenty-twentieths at all distances, but 
for the purpose of resting the accommodation, a 
+ 5 D is frequently resorted to for long and con- 
tinued close work. 

If serious nervous disturbances have been held 
in check by the above process, it is not advisable, 
after any given length of time, to prescribe glasses 
which will give fully twenty-twentieths of vision, 
but to increase their power .25 or .50 of a dioptre 
so as to produce about twenty-thirtieths, when 
practicable with the patient. Fogging fulfills a 
double purpose ; first, the tendency to repress 
ciliary innervation is continued ; next, the visual 
centers are relieved from taking impressions of 
numerous definable points, and great rest is often 
so attained. 

Fogging, for the discovery of high degrees of 



142 THE EYE IN ITS 

latent hyperopia where mydriatics fail, I believe 
to be entirely new. Naturally the criticism might 
be made that it would break down the accommo- 
dation. It certainly does break down a laborious 
accommodation that always exists where there is 
a high degree of latent hyperopia, which is mak- 
ing a constant and extravagant call on the nerve- 
centers. It breaks down a state of perfect 
accommodation that under highly abnormal con- 
ditions not only exists, but often proves very 
injurious to health. This is what it has always 
been our purpose to do with mydriatics. A new 
and more perfect accommodation is soon estab- 
lished, which is more favorable to conditions of 
health. 

In such localities as England, the northwest 
coast of North America, and similar sections of 
country where during a great part of the time the 
atmosphere is humid and foggy, nervous ailments 
are not so common, because the sharpness of 
vision is much diminished by the haziness of the 
atmosphere, and the sight centers of the brain are 
not exercised to the same extent as in a clear, 
bright view, where the most minute objects are 
distinctly seen, and constantly taxing the nerve- 
centers with their impressions. For vision is an 
active function even when it is the easiest pos- 
sible. It will often be found that besides 
repression, one of the results of fogging with 



RELATION TO HEALTH. 143 

glasses is a state of rest and quiet, and sometimes 
sleep. 

A question naturally rises here — Are the con- 
ditions which we are seeking to alleviate by re- 
pression of the ciliary, as well as by laborious 
attempts to repress the long muscles, of sufficient 
gravity to warrant the inconvenience to the 
patient ? The reply must depend on the state of 
the patient's health. 

Latent hyperopia is a condition of more or less 
perfect vision that is sustained by a constant and 
firmly fixed excess of innervation to the ciliary 
muscle. We will, in this immediate connection, 
consider myopia or near-sightedness, for I believe 
it properly belongs to the same line of thought. 
It is often the case that where the superior rectus 
is too short, the inferior rectus, instead of draw- 
ing the eye down to a balance with its fellow, 
draws it beyond, through an excess of nerve- 
force ; and myopia is a condition depending at 
first on a similar spasm. In my opinion this 
defect takes its origin nearly, if not always, as 
hypermetropia, but the nerve-impulse that in- 
creases the convexity of the lens to correct the 
hypermetropia, exceeds that office ; it passes the 
point where the refraction would produce clear 
and distinct vision, and near-sightedness is the 
result. It becomes an excessive impulse, fixed or 
progressive, arising from deranged nerve-centers. 



144 THE EYE IN ITS 

Thus myopia is the result of a nervous disturb- 
ance which causes an associated disarrangement 
in the impulses of assimilation in various parts of 
the eye, especially in the sclerotic coat. This dis- 
turbance in the nutrition of the sclerotic and 
other parts, tending to soften them and lessen 
their mechanical support, together with the press- 
ure of the rectus muscles, probably brings about 
that elongation of the eye that we find in axial 
myopia. The further these abnormal conditions 
proceed, the greater the source of irritation to the 
nerve-centers. In hereditary myopia, as in other 
hereditary diseases, there is undoubtedly trans- 
mitted a condition of the nerve-centers which 
tends to produce the difficulty. All evidence 
bears out the fact that myopes generally are 
people of a higher civilization, who exercise their 
eyes at the near point, and thus establish an 
abnormal impulse in the ciliary centers during 
such use of the eyes. The stimulus has been so 
constant for a long period that the impulse to the 
ciliary is unable to suspend itself and bring about 
distant vision again. The motive-impulse keeps 
coming. The ciliary will not relax from its con- 
tracted condition, the refraction remains high, 
and the patient near-sighted. This exercise of 
the ciliary centers through years, in one or more 
generations, causes a differentiation tending to 
produce an excessive ciliary impulse. 



RELATION TO HEALTH. 145 

In hyperopia, the nerve-impulse that causes 
the ciliary muscle to contract and increase 
the refraction of the crystalline lens, is 
abnormal, yet it performs a normal function; 
whereas in myopia the function and the im- 
PULSE are both abnormal. The circular fibres of 
the ciliary are hypertrophied in hypermetropia ; 
they are hypertrophied also in myopia previous to 
its becoming axial, but atrophied after it becomes 
axial, that is, when the eye begins to elongate ; 
for this elongation necessitates the suspension of 
ciliary contraction to maintain distinct vision even 
at the near point. As the eye elongates, the 
repression that goes on in the ciliary is of the 
highest type, being exercised at the near point, 
thus suspending the action of the circular fibres of 
the ciliary muscle, and their atrophy naturally 
follows. 

This natural forced repression, which increases 
with the progress of axial myopia, suspends the 
ciliary impulse more or less completely, and in 
such a case we should not expect those nervous dis- 
turbances that depend on ciliary strain ; but in a 
a mixed case, where concave glasses are worn for 
all distances, and the ciliary is taxed with the 
accommodative effort of the near point, I have 
sometimes found that the removal of the concave 
glasses for reading suspended some accompany- 
ing nervous condition. 



H 6 THE EYE IN ITS 

The following are some very interesting exper- 
iments in myopia which can be verified by any 
operator, and which prove that refractive myopia 
depends on ciliary spasm, and that, even in axial 
myopia, considerable repression can sometimes be 
made at the near point. In either class of cases, 
repression must be made at the near point. In 
various lengths of time, we shall be able to reduce 
the myopia one or two dioptres, sometimes more. 
In most cases satisfactory results will require con- 
siderable time and patience ; but a few experi- 
ments after the following example will suffice to 
show that in some very advanced stages of 
myopia, it is possible to suppress, or at least 
check, its onward course by repression at the 
near point. This fact renders the fitting of minus 
glasses to myopic eyes an open question. 

M. S., age thirty-five ; has been wearing minus 
glasses since the age of twelve ; obliged at various 
times to increase the power. When I saw the 
patient, she was wearing — 5 D for all purposes. 
Vision with each eye, at twenty feet, was twenty- 
twentieths, or normal. The addition of half a 
dioptre increased the acuity of vision to twenty- 
fifteenths, or above normal. A reduction of the 
power of the — 5 D glass to — 4.75 reduced the 
distant vision to twenty one-hundredths. This 
glass was worn one week, and the vision, instead 
of having been improved, was reduced to twenty 



RELATION TO HEALTH. 147 

two-hundredths. A return to the — 5 D restored 
the vision to twenty-twentieths. Vision was also 
normal at the near point. On removing the glasses 
she was able in a few minutes to read ordinary 
type at eight inches, but no farther. Repeated 
tests for half an hour resulted similarly. A +3 
D was now put on the patient, necessitating the 
holding of the type somewhat nearer to the eyes. 
After twenty-five minutes, she was able to read 
with +3 D at eight inches. After continuing 
them for an hour, and then removing them, the 
patient was able to read the same type at twelve 
inches ; but this condition was of short duration, 
necessitating the gradual approach of the letters 
until, within five minutes, the type was again eight 
inches distant. Under the high fusion power of 
the near point, the ciliary spasm had become 
repressed or partially suspended while the +3 D 
glasses were before the eyes, and it did not return 
immediately on removal of the glasses ; conse- 
quently the same print could be seen at twelve 
inches, but within five minutes the old innervation 
of the ciliary had re-established itself, necessitat- 
ing the holding of the print to within eight inches 
again. At the far point, in this test, the fusion 
power was not sufficiently high to permit of a 
reduction of .25 D in the — 5 D glasses. We see 
that it required fully twenty-twentieths of vision 
to bring about fusion power enough to prevent the 



1 48 THE EYE IN ITS 

ciliary spasm from increasing, for when it was 
reduced .25 D the myopia increased rapidly in one 
week. 

The patient was a constant reader, which it 
will be seen was a great aid to the results of my 
following effort. 

I prescribed a +3 D glass for all reading. 
This continued for thirty days during which time 
no concave glasses were worn for out-door or dis- 
tant purposes. When I again tested the vision for 
the far point, the patient could with — 4.25 D, 
bring out twentv-twentieths of vision, being a 
reduction of .75 D in one month. The same trial 
was continued for another month with a still fur- 
ther reduction of .25 D, making in all 1 D in two 
months. During this time, some favorable changes 
took place in the condition of the nervous system. 
Just how far we could have succeeded in time in 
reducing this case of myopia, we do not know. 
Impatience and the inconvenience necessary to this 
procedure, influenced the patient at this point to 
abandon the effort. Neither is it possible to state 
just how much of this myopia was axial, which 
amount, of course, would not have been influenced 
by the repression process. 

Age forty-three ; myopia ; had been wearing 
over the right eye — 1.25 D, left eye — 1 D, with 
little or no change for the space of two years ; 
eyes in use more or less at the near point. I 



RELATION TO HEALTH. 149 

recommended the removal of the concave glasses 
for distant vision and prescribed +3.50 D for 
reading, writing and other office work. After 
reading in these glasses for several days, the 
patient was able to read print twelve inches from 
the eyes. This patient was of more than ordinary 
intelligence and understood the aim of the effort. 
In six months I changed the glasses for reading 
and writing to a +4 D without seeing the patient. 
After using the +4 D glasses for several months 
he again came under my care for an examination, 
when the left eye gave twenty-twentieths of vision, 
while the right eye was very nearly the same, but 
the acuity was just perceptibly less. During this 
time the general health had improved somewhat, 
including considerable gain in the nervous condi- 
tion. Similar results have been attained in thir- 
ty-four like cases; but the process is very tedious 
for the patients, and unless their understanding is 
clear on the subject, it is almost impossible to 
induce them to undergo the trial. 

The foregoing in connection with limited tests 
of more than two hundred similar cases suggests 
an answer to that most important question, 'What 
shall we do to prevent myopia in school children 
and students ? ' 

In a nomad, who is reared out of doors, who 
follows such pursuits that his vision is mostly used 
at twenty feet and greater distances, the nerve- 



150 THE EYE IN ITS 

impulses to the ciliary muscle become established 
so that the easiest vision is for the far point, and 
in many years of such use, these impulses become 
more or less fixed ; while the child of a higher 
civilization spends its life within doors, amuses 
itself with toys, picture books, kindergarten 
amusements and learning to read. We will assume 
that such a child generally holds its book or toy 
ten inches from the eyes, in which case the crys- 
talline lens requires a much greater convexity, or 
higher state of refraction to bring about perfect 
vision ; and this is brought about by an increase 
in the ciliary nerve-impulse which contracts the 
ciliary muscle. Through long continued use, this 
excessive impulse becomes comparatively fixed, 
and in some instances refuses to suspend itself 
sufficiently to bring about distant vision again, 
and so myopia has set in. The regular work of 
the student and those other pursuits which re- 
quire the use of the eye at the near point, tend to 
perpetuate this disease and make it progressive. 
Again, the important question, ' How are the 
advantages of a high civilization to be attained 
without the foregoing disadvantages?' If the 
eyes are to be used at a distance of ten inches, aid 
them artificially by a ten inch magnifying glass ; 
then the nerve-impulses to the ciliary muscle 
will be no more than if the patient were leading 
an outdoor life and viewing objects at twenty feet 



RELATION TO HEALTH. 151 

or more. The nerve-centers are not called upon 
for so excessive an impulse, and they become 
habituated to sending the same amount of nerve- 
force as if an outdoor life were led. In conjunc- 
tion with this artificial aid to the ciliary centers, 
it, may be found advantageous to suspend, in 
a measure, the excessive nerve-impulses to the 
interni, by the use of prisms, base in. Under 
these artificial conditions, the eyes may be used 
in the attainment of all the advantages of the 
highest civilization while the nerve-centers are no 
more taxed than if out of door pursuits were being 
followed. If the little student at school or any 
other person using the eyes at the near point, 
were to be supplied with such glasses during 
the hours of study, on leaving the school room 
they could be taken off and the natural use 
of the eye at all other times would be quite 
sufficient to cultivate and establish the habit of 
accommodation. At least the danger of disturb- 
ing the accommodation would be much less than 
the dangers resulting to the eyes and nerve- 
centers without such aid. 

I simply suggest the above as a possible 
answer to one of the most important questions of 
the day. 

Astigmatism, or that condition in which the 
refraction of the eye is different in various meri- 
dians. Illustration : In the horizontal meridian, 



152 THE EYE IN ITS 

+2 D is required to correct the irregularity of 
refraction, while in the opposite or vertical meri- 
dian, +4 D is needed. Astigmatism is generally 
due to an irregularity of the spherical contour of 
the cornea, its curvatures being different in vari- 
ous meridians, requiring a stronger lens to correct 
it in one direction than the other. Corneal astig- 
matism is almost always due to the fact that some 
of the muscles of the eye ball are exerting greater 
tension in one meridian than another. For in- 
stance : A shortness of the internal or external 
muscle, inducing considerably more stress later- 
ally than the superior and inferior muscles exert 
in a vertical direction, would cause the cornea to 
be distorted horizontally, and vice versa. The 
many possible varying conditions of tension in the 
muscles produce corresponding deformities in the 
contour of the cornea, resulting in various forms 
of astigmatism. Wherever corneal astigmatism 
exists, it is fairly safe to conclude that it is due to 
some muscular strain. After correction of mus- 
cular defects, it is quite common for large amounts 
of astigmatism to disappear, and leave the eye in 
perfect, spherical shape. In the foregoing 
remarks, I refer to corneal astigmatism only. 



RELATION TO HEALTH. 153 



X. 



THE short or stretched muscles never assume 
much if any normal action. They are 
always being stretched and relaxed again, conse- 
quently they are thin, attenuated, and undevel- 
oped. 

Under this irregular condition, the most deli- 
cate correlated action exists in the various move- 
ments of the eye, just as if perfect anatomical 
conditions existed. The nice relation existing 
between the accommodative effort of the ciliary 
muscles and the relative convergence of the optic 
axes to fix them for various distances, is main- 
tained to a mathematical nicety. In exophoria, 
where convergence is performed by a contraction 
of the internal recti, and divergence is performed 
by a relaxation of the same, it is the amount of 
innervation sent to the interni that in part estab- 
lishes our judgment of distance. In a marked 
case of esophoria or short internal muscles, where 
the act of divergence from the near point to par- 
allelism is performed by an excessive contraction 
of the external muscles, and convergence to the 
near point by a relaxation of the same, it is the 
variation of innervation to the external muscles 



154 THE EYE IN ITS 

combined with the effort of the ciliary muscles 
that determines our judgment of distance. 

In esophoria, or convergence due to short 
internal muscles, where their length is such that 
the optic axes would be converged for a distance 
of ten or twelve inches during the absence of 
innervation, it is through the agency of nerve- 
impulse to the external muscles that the optic 
axes are drawn into parallelism for distant vision; 
and when the near point is again sought and the 
ciliary accommodation increases the refraction, 
it is not as has been generally assumed, an asso- 
ciated contraction of the internal muscles that 
converges the eyes; it is a negative action, a sus- 
pension of innervation to the external muscles. 

The nice and delicate correlated action of the 
various parts of the eye has been assumed by 
some to be a delicacy of mechanical balance of 
the various muscles, but this is seldom if ever 
true. In nearly all cases, the balance is main- 
tained by innervation which is the outgrowth of a 
stimulus in the nerve-centers for perfect vision. 
In such cases, the abnormal nerve-impulses have 
continued so long in the performance of their 
various duties, that they have become fixed 
impulses and they are virtually interlocked with 
each other. 

There are numerous cases of defective eye- 
balance where short and abnormally innervated 



RELATION TO HEALTH. 155 

muscles exist in one or more situations which 
seem to be firmly and most fixedly locked 
throughout, one with the other. To make myself 
thoroughly understood, I will assume to know 
just how much tendency to deviation there is in a 
given case in the absence of innervation. The 
left superior is short enough to cause the eye to 
deviate 6 deg. upward, and the two externals 20 deg. 
outward, while the ciliary is making up for 3 diop- 
tres of latent hyperopia. All of these conditions 
are latent. Excessive innervation of the inferior 
muscle pulls the eye down against the short 
superior; abnormal innervation to the interni 
draws the eyes to a balance against the short 
externals, and the ciliary at the same time is mak- 
ing up the 3 dioptres of deficient refraction in the 
crystalline lens, until the function of perfect vis- 
ion is the result, and all defects are hidden. 
It sometimes is a very tedious and puzzling 
problem to upset or unlock this correlated con- 
dition of abnormal impulses, and reveal the 
defects. If the abnormal innervation of one of 
these muscles can be interfered with and broken, 
there will be a general unfolding of all the 
defects. It is sometimes difficult to know where 
to begin. A few hours' or days' fogging may 
relax the ciliary spasm, and, after it has yielded, 
defects in other muscles will begin to manifest 
themselves; then development in that particular 



156 THE EYE IN ITS 

direction may be taken up and followed until 
the condition of the eye is revealed with abso- 
lute certainty, by careful adherence to symptom 
tests. 

Sometimes the ciliary spasm does not readily 
yield to fogging, in which case it may be easier 
to discover some defect in one of the long 
muscles, for illustration, the left superior. In 

this case an examination with dots 

or lights might show the two 

objects to be perfectly horizontal, 

— or so nearly so that the patient 

could not discern that one light 

was higher than the other. By 

<JL- using a chart with a star or dot in 

the middle, and lines drawn hori- 
« zontally across the chart both 

^_— — ^— above and below the dot, equi- 
______^___ i distant from each other so as to 

represent for each space 1 deg. at 

the distance of examination. By 
the use of a 5 deg. prism, base down, first before 
one eye and then before the other, there will in 
each position appear to be two stars, with possi- 
bly four lines between the stars in each posi- 
tion. We then reduce the prism to 4 deg. and 
find the same result; then to 3 deg., where we 
may possibly find that a difference will manifest 
itself. That is, with the prism, base down, 



RELATION TO HEALTH. 157 

before the right eye there will perhaps be two 
stars, while before the left eye there will appear 
only one. Or, if there be no difference with 
the 3 deg. prism, we resort, to a 2 deg. prism, 
with which, if there is any difference, we shall 
discover it by there being perhaps two stars 
before the left eye with no lines between, while 
before the right there may be two stars with one 
line between; or we may have to use a 1 deg. 
prism before we find the difference, which will 
possibly be fusion before the left eye, while there 
are two stars with the same prism, base down, 
before the right. Perhaps even here the only 
difference that can be noted will be that the vision 
is much more perfect with the 1 deg. prism, base 
down, before the left eye and more indistinct in the 
same position over the right. We can then place 
in our trial frame a 1 deg. prism, base down, 
before the left eye. In ten minutes, more or less, 
the same eye will be able to accommodate itself 
for 2 deg., and a little later for 3 deg., 4 deg., and 5 
deg., and so on up sometimes to 8 deg. or 10 deg. 
within an hour or two, while at the beginning the 
eyes could not accommodate themselves to 1 deg. 
or 2 deg. of prism in the same position. The sur- 
mounting of this difficulty will sometimes cause a 
tonic unyielding spasm in the ciliary to begin to 
manifest itself, where it would not readily do so 
as represented above by fogging. It may also 



158 THE EYE IN ITS 

unfold some defect in the internal or external 
muscles. 

We can with advantage oftentimes carry on 
repression in three directions at the same time. 
For instance, as in case 11, page 105, ciliary- 
repression with +3D spherical, left inferior rectus 
14 deg., base down, with 18 deg., base in. The 
suspension of repression in any one of these three 
directions in this case materially aggravated the 
symptoms. Inasmuch as fogging diminishes the 
fusion stimulus for the distance, we are often 
obliged to sacrifice some repression in this direc- 
tion for the purpose of increasing it in another, 
or to increase repression in this direction by 
sacrificing it in another. Extraordinary care, 
patience and judgment are necessary at all times 
in the process of repression. Considerable 
variations in the condition of the nerve-centers 
ranging from depressed to more exalted states, 
often oblige us to retreat by reducing our prism 
in one or more directions for the purpose of 
remaining within the range of fusion. In some 
cases this will occur repeatedly, and at times may 
have a tendency to confuse us. Such circum- 
stances should make us doubly careful, but should 
not deter us from attacking the same position 
again as soon as practicable. 

The following is a continuation of the test of 
the vertical muscles where they will accommodate 



RELATION TO HEALTH. 159 

for larger amounts of prism. It has been a com- 
mon practice to use a 3 deg. prism, base down, 
first before one eye and then before the other. If 
fusion takes place in both these positions, the 
inference has been that there is nothing defi- 
cient in a superior or inferior muscle ; but this 
conclusion is erroneous, for serious defects may 
exist without the above test giving the slightest 
indication of it. 

When fusion takes place with a 3 deg. prism, 
base down, before either eye, we should next re- 
sort to a 4 deg. prism. If fusion takes place with 
this, we should then use a 5 deg., and continue to 
increase the power of the prism until the highest 
degree is reached where fusion will take place. 
It may be six, seven or even more degrees, and if 
fusion takes place before one eye equally with 
the other, there is apparently no difference as 
recorded by this test. If, on arriving for instance, 
at a 7 deg. prism we find it will fuse before the 
left and constantly refuse to do so before the 
right eye, we assume to have discovered a short- 
ness in the muscle toward the apex of the prism 
where the highest fusion takes place, and the cor- 
rectness of our inference should always be verified 
by symptom tests. 

Now, before the eye that fuses for the highest 
degree of prism, we continue to add more, until 
we have reached the highest number of degrees 



160 THE EYE IN ITS 

under which fusion will take place, which may 
possibly be ten or more degrees of prism more 
than the opposite eye would fuse for. If any 
such result is obtained, we should take off all 
prism for a time and repeatedly endeavor, by 
careful coaxing, to see if the eye that accepted 
the less prism can in any way be drawn to take 
on an equal amount with the other eye. If it 
persistently refuses to do so, we should then 
apply to the other eye all that it will accept. 
During this time we should constantly observe 
what changes, if any, take place in some promi- 
nent symptom or symptoms of the patient's dis- 
order. If there be a marked change for the better 
in the action of the heart, or in some other con- 
dition, it is evident that we are turning the eye in 
the direction of the short muscle and repressing 
the abnormal innervation in the opposite ; but if 
the disturbed conditions are emphasized as we 
proceed, it is very evident that the eye is being 
turned in a wrong direction and that we are being 
led on by a short muscle, the shortness of which 
is due to spasm and not an anatomical defect. In 
this case we are increasing the abnormal innerva- 
tion and the irritation of the nerve-centers. 

During our first efforts at repression we may 
not at once effect sufficient change in the dis- 
turbed conditions of the patient to assure us that 
our repression is correct, in which case we should 



RELATION TO HEALTH. 161 

turn our test prism in the opposite direction ; then 
if all the unfavorable symptoms be aggravated, 
we have some assurance at least that the last 
position was wrong, and therefore we return to 
the first position and proceed with caution and 
patience. 

During all tests the color of the skin, the 
action of the heart, the warmth of the hands and 
feet and the general feelings of the patient should 
be carefully inquired into, for sometimes a spasm 
will turn the eye 8 deg. or io deg. in a direction 
opposite to the short muscle. The only safe way 
of discovering this spasm is to note the symptoms 
of the patient as we proceed, exercising at all 
times the greatest care in drawing our conclu- 
sions ; for a pleasant stimulated feeling sometimes 
follows the turning of the eye in the direction of 
the spasm ; but such a change is of a temporary 
character, and a few hours or a few repetitions of 
the experiment will suffice for the manifestation 
of unfavorable symptoms. Again, when we are 
developing in the proper direction, disturbances 
of a transitory character will sometimes arise, but 
these are not an aggravation of the symptoms of 
the disease. They should always be subdued. 
If we are really repressing, the probability is that 
the temporary disturbances arising are all new 
symptoms. The exceptions exceed any general 
rule that can be laid down in this practice, and 
ii 



162 THE EYE IN ITS 

each case presents features that require individual 
care. 

Sometimes we may be fortunate enough to 
have such marked changes ensue from repression 
that there will be little uncertainty. I have seen 
it reduce the heart's action within one hour from 
120 to 65, where on the removal of the glasses the 
heart in a short time would increase to its former 
standard, and again with the glasses be reduced. 
I have repeatedly seen persistent pains in the 
back, the ovaries, the stomach and various other 
parts relieved within an hour or two, and repro- 
duced by the removal of the glasses or the 
reversal of the prisms. I have seen the reverse 
position produce a nervous chill. There cer- 
tainlv is as much mental-suggestion in one posi- 
tion of the prism as the other. 

There may be fully as much consciousness of 
effort in a repressive strain that suspends impulse 
as if it were a direct one requiring innervation to 
sustain it. 

During repression, when the excessive impulse 
has been partially suspended, it will sometimes 
suddenly return, and with it the disturbing and 
annoying symptoms of the disease will be aggra- 
vated, but we must not be misled by this, for it 
is a thing of frequent occurrence. Abnormal 
innervation is very obstinate and is repressed 
slowly. The longer repression is persisted in, the 



RELATION TO HEALTH. 163 

less likely is spasm to occur ; but, when it does, 
the patient is unable to fuse any longer under the 
prism which was worn just before its return. In 
this case the prism should be reduced to a pos- 
sible point of fusion again, for if the full 
amount is continued the fusion stimulus is lost 
and the spasm runs riot ; but if the prism is re- 
duced to that point where fusion can take place 
again, the spasm will be held more or less under 
subjection, after which we can gradually increase 
the prism again to the point where the spasm oc- 
curred, and in time get beyond it. These annoy- 
ances occur far short of full development, with 
only 2 deg., 3 deg. or 4 deg. of prism, where 
later the same case may develop 15 deg. or 20 
deg. with much improvement. In excessively 
nervous people these spasms are quite frequent, 
but when we have discovered beyond a perad- 
venture where the abnormal innervation is, 
we can force our position against all adverse 
symptoms. 

As THE CILIARY SPASM IN HYPEROPIA FRE- 
QUENTLY PASSES BEYOND THAT POINT WHERE PERFECT 
VISION IS THE RESULT, AND TOO HIGH A REFRACTION 
OBTAINS (MYOPIA), SO WE MAY AS OFTEN EXPECT 
THAT THE LONG MUSCLES, IN THEIR EFFORT TO 
OVERCOME SOME ANATOMICAL DEFECT, HAVE 
EXCEEDED THE INTENTION OF THEIR EFFORT TO 
CORRECT, AND TURNED THE EYES IN A DIRECTION 



164 THE EYE IN ITS 

OPPOSITE TO THE SHORT MUSCLE. THIS IS A 

REVERSE-MANIFEST EYE-STRAIN AND VERY COMMON. 

When abnormal nerve-impulses have become 
thoroughly established through the medium of 
defects in the visual apparatus, and loss of sight 
occurs, all means of repression through the 
medium of the eyes is lost. If abnormal impulses 
depended upon a stimulus for their continuance, 
blindness would be the end of them; but inasmuch 
as these impulses become firmly and fixedly 
established, they will not suspend themselves 
without the interposition of repressive strain. 

When eyes deviate from parallelism, the 
deflection is due to one of two causes, either a 
short muscle or a spasm. Again, the spasm may 
be due to an effort to correct a short muscle or to 
fixed abnormal nerve-impulses that are the out- 
growth of long continued strained positions of 
the eyes, as in writing, reading, painting, mining, 
watchmaking and all kinds of labor where the eyes 
are in constant use at the near point, or in some 
unnatural position. 



RELATION TO HEALTH. 165 



XI. 



ORTHOPHORIA: Regular or correct tending 
of the optic axes. 

Heterophoria: Different tending of the optic 
axes. 

Esophoria: Inward tending of the optic axes. 

Exophoria: Outward tending of the optic axes. 

Hyperphoria: Upward tending of the optic 
axes. 

Cataphoria: Downward tending of the optic 
axes.* 

The above terms have heretofore been used 
in a relative sense; namely, esophoria, a relative 
tending of the optic axes toward each 
other; exophoria, a relative tending from 
each other; hyperphoria, in which the one 
axis is relatively higher than the other; 
and cataphoria, in which it is lower. A person 
with but one eye may have any one of the above 
conditions. The optic axis of a single eye may 
turn inward, outward, upward or downward from 
what would be a normal position, giving rise to 
considerable disturbance and strain, especially if 

* We are indebted to Dr. George T. Stevens, of New York, for the 
above nomenclature. 



1 66 THE EYE IN ITS 

a glass is worn, in which case the clearest vision 
is sought through its center, necessitating the 
holding of the eye in a normal position. If a 
glass is not worn, the head is usually thrown into 
that position which most relieves the strain. If 
the upper muscle is short, the chin is thrown 
down and the forehead forward; if the lower, the 
chin is thrown up and the head back; but if the 
short muscle is the outer or the inner, the eye 
rather than the head is usually turned so as to 
relieve the strain. These conditions are quite 
common in persons with but one eye, so I think 
it would be well to discriminate between relative 
and individual heterophoria. 

By considering only the relative position of 
the two eyes, we are likely to overlook some 
grave defect in the ocular muscles, for it is pos- 
sible for both of the superior or both of the in- 
ferior muscles to be short in connection with a 
relative deviation or a relative balance. Short- 
ness of the external of one eye and the internal 
of the other may exist, and still a relative balance 
be maintained. We may often fall short in our 
investigation by taking into consideration only 
the relative position of the lines of sight. There 
are cases that should require months of careful in- 
vestigation before safe conclusions can be drawn. 

Defective length and defective attachment of 
the oblique muscles will sometimes be found. I 



RELATION TO HEALTH. 167 

have met with two cases of this kind in which 
there was a very manifest turning of the ball on 
its antero-posterior axis when an effort was made 
to move the eye laterally. With the assistance 
of Dr. C. S. Hamilton, of Toronto, I operated on 
one of these cases by making a complete division 
of the superior oblique muscle at its ocular 
attachment with the result that the twisting 
movements of the eye ceased and there was 
very marked improvement in the nervous symp- 
toms from which the patient had suffered previ- 
ously. 

From the fact of the convergence and diver- 
gence necessary for the accommodations for vari- 
ous distances, defects are much more likely to be 
manifest in the external and internal muscles than 
in the superior and inferior muscles, because 
during their functions there is never any devi- 
ation from a horizontal plane. Both eyes 
move upward and downward simultaneously and 
equally, and through such constant use the 
nerve-impulses to these muscles establish a very 
fixed horizontalizing tendency. 

DIFFUSION TESTS. 

Place a red or highly colored plain glass before 
one eye. The dissimilarity in color in some cases 
will disclose a lack of parallelism of the lines of 
sight. 



1 68 THE EYE IN ITS 

A plus lens of 10 dioptres, more or less, 
covered with a disc with a small opening in its 
center which permits one eye to see only directly 
through the center of the lens, renders two lights 
so dissimilar in shape that diffusion will some- 
times occur. 

The Maddox rod placed before one eye dis- 
torts a light into a long beam of light, while the 
same object seen by the other eye retains its 
natural shape, and any manifest deviation can be 
discovered. 

Another ingenious instrument for creating dif- 
fusion, is Mr. Brayton's Optomyometer, which 
consists of two hollow tubes about eighteen inches 
in length, through which the eyes of the patient 
look at a plain, smooth curtain or surface. When 
diffusion takes place two round spaces appear. 
These cylinders or barrels are so arranged that they 
can then be moved from their parallelism into a 
position that brings the two objects together, the 
degrees of deviation being measured by a pointer 
on the instrument. The fusion stimulus can be 
decreased in this instrument by adding any one 
of the above mentioned three implements to one 
of the eye barrels. 

Direct the patient to look steadily at a light 
or some fixed object, covering one eye with a 
card. After a minute or two, suddenly change 
the card over to the opposite eye and inquire of 



RELATION TO HEALTH. 169 

the patient if any apparent change occurred in the 
position of the light. Sometimes by this test we 
are able to see the eye move as it fixes itself on 
the light when the card is changed. 

Place before the eyes enough prism, base in, 
to create diplopia, being careful that the axes of 
the prisms are horizontal and the head of the 
patient erect, and a single light or object appears 
as two, the object on the right side being seen by 
the right eye, and that on the left by the left. If 
either object appears lower than the other, the 
indication is that the eye on the same side is 
higher. 

Place sufficient prism, base down, before one 
of the eyes to create diplopia, being careful that 
the axes of the prisms are vertical and the head 
erect, thus making a single light or object appear 
as two. If the lights are relatively vertical, there 
is an apparent balance ; but if with the prism 
base down, before the left eye the upper object is 
to the left, there is a manifest convergence of the 
eyes ; if to the right, a divergence. 

Two prisms held together, base to base, by an 
eyeglass rim, if placed before the center of the 
pupil of the eye, with their axes horizontal, create 
for that eye two apparent objects. The other eye 
will see the real object between these two, if the 
prisms are of sufficient strength. If the middle 
object seen with the uncovered eye is higher than 



17° THE EYE IN ITS 

the other two, then that eye is lower ; and con- 
versely, if the object is lower the eye is higher. 
If the prisms are not of sufficient strength, the 
uncovered eye may fuse its object with one of the 
other two images. By now turning the axes of 
this prism vertical, the two apparent objects are 
seen by one eye, one above the other, and any 
deviation of the middle or third object indicates 
a deviation in the lateral muscles. 

This double prism test has no advantage over 
the single prism test, if indeed it does not possess 
one disadvantage, namely that of multiplying the 
objects ; for the fact of there being two exactly in 
the horizontal plane offers a higher stimulus for 
the other eye to horizontalize, or bring its image 
into the vertical plane. There being two appar- 
ent spots exactly vertical, the stimulus to verti- 
calize by the lateral muscles is emphasized.* 



*See horizontalizing and verticalizing tendencies, pages 
2,7 and 38. 



RELATION TO HEALTH. 17: 



XII. 

THE superior oblique muscle receives its nerve- 
supply through the Fourth Cranial nerve ; 
the external rectus, through the Sixth ; the supe- 
rior, inferior, internal rectus, both obliques and 
the ciliary, through the Third. 

That various parts receive their nerve-supply 
from the same nerve does not imply that their 
functions are necessarily similar, or that the gov- 
erning nerve-centers are in the same locality ; for 
two fibrilla in a nerve, lying side by side, may 
have the most widely separate origin possible in 
the nerve-centers. 

Considered individually, the actions of the 
long muscles of the eye are as follows : The ex- 
ternal rectus turns the eye outward ; the internal 
inward ; the superior, upward and slightly inward 
with a tortional movement of the upper aspect of 
the eye toward the nose. The inferior moves the 
eye downward, slightly inward with a slight tor- 
tion of the upper aspect of the eye from the nose. 
The superior oblique makes a tortion of the upper 
aspect of the eye toward the nose, with a slight 
movement of the optic axes outward and down- 
ward ; the inferior oblique produces tortion of 



172 THE EYE IN ITS 

the upper aspect from the nose, with a small 
tendency to turn the optic axes outward and 
upward. 

Considered relatively, there are four antagon- 
istic sets of muscles : First, the superior and 
inferior recti ; second, the external and internal ; 
third, the superior and inferior obliques ; fourth, 
the superior and inferior recti as antagonized by 
the superior and inferior obliques. The latter set 
slightly diverges the optic axes, and the former 
set slightly converges them. 

There are six sets of synchronously acting 
muscles : First, the superior recti turn both eyes 
upward ; second, the inferior recti move them 
downward ; third, the right external and left in- 
ternal recti turn both eyes to the right ; fourth, 
the left external and right internal recti turn both 
eyes to the left ; fifth, the superior and inferior 
obliques of the right eye, acting together, in con- 
nection with the superior and inferior recti of the 
left eye, have a tendency to turn both eyes slightly 
to the right; sixth, the superior and inferior ob- 
liques of the left eye, acting synchronously with 
the superior and inferior recti of the right eye, 
turn the eyes slightly to the left. 

A still further secondary action takes place as 
follows: When the eye is turned upward so that 
the relative equator of the eye-ball is thrown 
below the parallelism of the internal and external 



RELATION TO HEALTH. 173 

recti, a contraction of these muscles will assist in 
turning the eye upward. Conversely, when the 
eye is turned downward so that its equator lies 
above the line of these muscles, their contraction 
will assist in turning the eye downward. When 
the eye is turned outward so that its equator lies 
inside the line of the superior and inferior recti, 
their contraction would assist in turning the eye 
outward. When the eye is turned inward so that 
the equator lies outside of the line of the superior 
and inferior recti, their contraction would assist 
in turning the eye inward. 

In taking into consideration the chief action of 
any one or more muscles, the above associated 
movements should always be understood and 
considered. 



174 THE EYE IN ITS 



XIII. 



ESOPHORIA, or a tendency to a convergence 
of the optic axes, is the most deceptive and 
troublesome condition with which we have to 
deal, and from its very nature we can see how 
unreliable all diffusion tests are, as indicating the 
true conditions. 

We will suppose a case where the lengths of 
the various long muscles of the eye are such that, 
without effort the axes of the two eyes are per- 
fectly parallel at a distance of twenty feet or more. 
The muscles, in performing their functions at an 
infinite distance make their movements in various 
directions synchronously, the superior muscles 
turning both eyes upward, and the inferior mus- 
cles turning them downward. Turning to the 
right, the right external and the left internal act 
together, and the necessary innervation is com- 
pensated for when the two eyes are directed to 
the left ; for then the left external and the right 
internal require an amount of innervation equiva- 
lent to that required for the movement in the 
other direction. 

Supposing the various inclinations of the head 
to the right and to the left to be of nearly equal 



RELATION TO HEALTH. 175 

frequency, the oblique muscles will also be uni- 
formly exercised. Thus in the various movements 
of the eye at a distance, there is a tendency to 
establish more or less of an equilibrium in the 
nerve-impulses that contract the various muscles ; 
but when the vision is fixed upon some object at 
a near point, as is necessary in reading, writing 
and in the pursuit of various mechanical arts, the 
internal rectus muscles receive an amount of 
nerve-force necessary to break the parallelism of 
the infinite distance, and turn the eyes toward 
each other. The repeated exercise of the internal 
muscles has a constant tendency to develop their 
power, and there is no counter movement of the 
eyes in which the opposing muscles have any 
opportunity for a like development. It is for this 
reason that we always find the internal muscles 
much stronger than the external ; but the differ- 
ence in strength between the internal and external 
muscles has no tendency to cause the eyes to 
deviate from perfect parallelism at a distance. 
Under normal conditions there remains the ability 
to suspend the nerve-impulse that gives greater 
strength to the internal muscles. When the eyes 
are removed from the near to the remote point 
the relaxation is a negative act yet a normal func- 
tion. There is no contention between the inter- 
nal and the external muscles. Under normal 
conditions, the function of suspending nerve-im- 



176 THE EYE IN ITS 

pulse exists in all the ocular muscles ; when cer- 
tain muscles contract to perform some office their 
opposites relax to assist them. In the fullest 
sense this suspension of nerve-impulse is probably 
not absolute. Just sufficient impulse continues to 
give the eyes a steady position ; but, where the 
employment of the eyes has been such as to 
necessitate their use at the near point constantly, 
from morning until night, day after day (as in the 
case of an inveterate reader or writer, or an arti- 
san with his work constantly close to his eyes), 
the nerve-impulses of the internal muscles are 
almost constant, with little or quite infrequent per- 
iods of relaxation; thus the impulse becomes such 
a fixed and constant quantity that ultimately there 
is an inability to suspend it entirely. Such eyes, 
when examined at a distance of twenty feet or 
more, show a positive tendency toward conver- 
gence, while at the near point we may find a bal- 
ance, a convergence, or even a tendency to diver- 
gence, as a result of the excessive abnormal 
innervation. 

By diffusion tests a convergence may appear 
where the external and internal muscles are of 
proper length, when it is apparent esophoria ; or it 
may appear where the externals are short, in which 
case it is a reverse manifestation; or it may appear 
where the internals are short. Of the three con- 
ditions, the last is the least likely to be the fact. 



RELATION TO HEALTH. 177 

Esophoria is the most confusing and obstinate 
condition with which we have to deal. The 
above demonstrates how dangerous it is to rely on 
any diffusion test as an indication of the true 
anatomical condition of the ocular muscles ; and 
it is not strange that, by so doing, many have been 
thrown into doubt and confusion as to the impor- 
tance of this field of work. Repression, in which 
symptoms are our chief guide, is the only method 
of safely determining whether the diffusion tests 
have given a true or false indication of the condi- 
tion of the muscles. The majority of cases of 
manifest esophoria are reverse manifestations, or 
due to spasm. When esophoria exists at the far 
point, and exophoria at the near, it is pretty safe 
to conclude that it is not true esophoria. 

EXOPHORIA. 

Of all defects, this is undoubtedly the most 
common. The tendency of the optic axes to 
diverge may, as in other muscular defects, be due 
to shortness of the external muscles, or it may 
be apparent exophoria, due to spasm, receiving 
its initial source of irritation from a latent defect 
in some one of the other muscles, more usually a 
superior or inferior. Or, it may possibly be a 
reverse manifestation. In short, strain in any one 
of the ocular muscles may give rise to a spasm 
and apparent defect in any of the others, and 



I7 8 THE EYE IN ITS 

repression is the only method that will determine 
with any safety the actual state of affairs. When- 
ever exophoria exists at the near point, I always 
endeavor by repression to develop an exophoria 
and in most instances succeed. Also in some 
cases where esophoria exists at the near point, 
repression will develop a true exophoria, the cer- 
tainty of which is rendered positive by the physi- 
cal relief which accompanies the development. 

HYPERPHORIA AND CATAPHORIA. 

A greater amount of defect is likely to be 
latent in the superior and inferior than in the 
external and internal ocular muscles, for the latter 
in the performance of their various functions are 
alternately converging and diverging their optic 
axes, while the superior and inferior never cause 
any relative change in the optic axes, upward or 
downward, during their work. Whatever position 
they assume, the optic axes never deviate rela- 
tively from a horizontal plane ; consequently the 
impulses to the superior and inferior muscles 
become more obstinately fixed, and defects in 
these muscles are less likely to manifest them- 
selves. If the superior muscle of one of the eyes 
is short, and the inferior muscle of the same eye 
is sufficiently innervated it will draw the eye down 
into line with its fellow. Day after day nerve- 
impulse is sent to the inferior muscle, contract- 



RELATION TO HEALTH. 179 

ing it and holding the eye in place. During 
months and years this process goes on until the 
nerve-centers become accustomed to manufactur- 
ing and sending out this excessive nerve-impulse, 
and perfect vision is performed. At the age of 
thirty, more or less, the short muscle, having 
been constantly kept on the stretch, is naturally 
weak and undeveloped. Its length is greater than 
normal conditions would have left it. It has 
always been stretched by the opposite muscle, 
which has contracted to draw the eyes into line, 
while the contracted or innervated muscle is 
over-developed, having received for thirty years 
an excessive amount of nerve-impulse to perform 
its work, an amount of motive-force for which the 
nerve-centers were not originally intended to be 
drawn upon. In time, through differentiation, 
the nerve-centers become accustomed to generat- 
ing and sending out this excessive amount of 
motive-force for the purpose of maintaining per- 
fect vision ; thus the impulse becomes a fixed 
one requiring no further stimulant to call it forth. 
It becomes fixed in sufficient force to establish a 
balance between the two eyes even when prisms 
or other diffusion tests are resorted to for the pur- 
pose of ascertaining if one eye is higher or lower 
than the other. Although we have created dip- 
lopia, the eye does not turn toward the short 
muscle, because the nerve-impulse that opposes it 



I So THE EYE IN 'ITS 

pulls just as hard as the short muscle does. It 
has become an absolutely fixed impulse requiring 
no stimulus to generate it. It is as fixed as the 
impulse that carries on the action of the heart or 
the functions of the liver. Under these circum- 
stances it is useless to expect any diffusion test to 
reveal a muscular defect if it is present. 

From this excessive demand for motive-force 
irritation frequently results in the centers that are 
furnishing it; the impulse becomes stronger than is 
necessary to hold the eye down in line ; and, when 
diffusion tests are made, it is pulled below or in a 
direction opposite the short muscle (reverse man- 
ifestation). To attempt to correct such a defect 
as manifested by diffusion would increase the ner- 
vous disturbance. Repression in connection with 
symptom tests is the only safe procedure. 

During repression by crowding on all the prism 
that the eyes will fuse under we cannot expect 
this short muscle in a few weeks or even months 
to assume its normal length. Will it be as short 
as it would have been had it never been stretched ; 
or would the opposite or excessively innervated 
long muscle under this process become stretched 
to a length that is in any way equivalent to the 
stretching that has taken place in the short muscle 
during a period of thirty years ? This question is 
a sufficient answer in itself. 

When we have discovered that a defect exists 



RELATION TO HEALTH. 1S1 

in the superior or inferior rectus muscle, it is 
important to determine whether it is hyperphoria 
or cataphoria ; for to select the superior muscle as 
being invariably the defective one will prove 
wrong. Dr. Stevens has pointed out the fact that 
the head is usually tilted toward the shoulder 
opposite the eye which tends the higher ; in other 
words, it is tilted toward the shoulder on the side 
next to the eye which tends the lower, or would 
in the absence of innervation. Now, it is very 
important to determine whether this tendency is 
due to a short inferior muscle in one eye or a 
short superior in the other. This I think can 
safely be determined by noting another position 
of the head. If, in connection with the side incli- 
nation, the head is constantly thrown backward 
and the chin elevated, the inferior muscle will 
prove to be short ; but if it is inclined forward 
with the chin resting well down toward the breast 
bone, it is evident that the superior muscle is 
short. These positions should be carefully noted 
during repression tests, and if the chin is thrown 
up and the head back, the greater amount of our 
repression prism may be put on, base up, which 
will have a tendency to lower the chin. If the 
head is ducked forward, we may put on the greater 
amount of repression prism, base down, which 
will have a tendency to raise the chin into a more 
normal position. 



1 82 THE EYE IN ITS 

Before operating on an eye the oculist should 
determine several important things. First, is the 
patient's condition a serious one, and does it in a 
great measure depend on eye defects ? The 
result of our examination by repression will 
determine this for us, for if prominent symptoms 
can in this way be subdued, we have reason to 
feel encouraged. Next, have the tests developed 
a sufficient defect in the ocular muscles to warrant 
an operation? If the defective muscle is a supe- 
rior or inferior, and the repression has not dis- 
closed more than 10 deg. or 12 deg., treatment 
with prisms may be the more practicable. This 
in no way relates to defects as developed by diffu- 
sion tests. In a case in which no more than 10 
deg. or 12 deg. have been developed by repres- 
sion, partial tenotomy might possibly bring the 
optic axes up or down into line ; but it would not 
leave as true normal conditions as prisms. A 
partial tenotomy in which three-fourths, more or 
less, of a tendon is divided leaves the other one- 
fourth of the tendon on the stretch. It offers 
less, yet a proportionate amount of resistance. 
If it permits the eye to turn sufficiently far, the 
cut fraction may assume in a small measure the 
functions of a normal muscle, but this is forever 
out of the question with the uncut portion. 

If the muscles are so attached to the ball that 
one of the eyes deviates from its fellow 20 deg., 



RELATION TO HEALTH. 183 

when the eye is in this position the muscles are of 
proper length and all innervation will be sus- 
pended ; but when this eye is moved into line 
with its mate one muscle is too short and the 
other too long ; consequently, if the deviation is 
within the practical limits of the use of prisms, 
the eye is rotated into that position in which both 
muscles are of proper length, and from this posi- 
tion the associated movements of the eye will call 
upon each muscle for its proportionate share of 
normal function. 

If primarily an eye had a tendency to deviate 
in any direction — for illustration, outward one- 
fourth of an inch — and innervation to the opposite 
muscle has lined the eyes up and held them in 
proper position for a space of years, during this 
time the short muscle has been stretched to one- 
fourth of an inch greater than its natural length, 
while the long muscle, by contraction, has taken 
up one-fourth of an inch of excess in length. 
Under these conditions the short muscle is longer, 
and the long muscle shorter one-fourth of an inch 
than they would have been had their lengths been 
normal primarily. Therefore, under these circum- 
stances, a lengthening of the short muscle by 
tenotomy does not by any means fulfill all the 
requirements of the case. It is true that the short 
muscle needs greater length ; but, for a normal 
position of the eye, we must remember, also, that 



184 THE EYE IN ITS 

the opposite muscle has always been too long ; 
and if we relieve the strain in the short muscle, 
thus allowing the eye to maintain a normal posi- 
tion with less work, the long muscle on the oppo- 
site side must contract upon itself by excessive 
innervation a sufficient amount to shorten itself 
one-fourth of an inch before it can assume normal 
functions ; and the necessity of shortening this 
muscle to avoid this innervation is oftentimes as 
necessary as the lengthening of the short muscle. 
When a short muscle has been stretched by its 
vis-a-vis for many years, and an operation is per- 
formed which gives it greater length and removes 
the stress upon it, the short muscle that has been 
stretched begins to shorten itself after the opera- 
tion by assuming a normal activity that it never 
before had an opportunity to assume. After the 
operation the short muscle has a chance to act for 
the first time in its existence. It continues to 
shorten week after week, month after month, and 
will usually take up several degrees of deviation 
made in the opposite direction by the operation. 
This process of shortening continues to such an 
extent that in variable lengths of time it will 
obliterate double vision to the amount of 10 deg. 
to 20 deg., and often a deviation in the original 
direction will ultimately present itself again, re- 
quiring still further correction by a repetition of 
the operation. Often it is deemed necessary to 



RELATION TO HEALTH. 185 

lose a limb to save life, and the little temporary- 
discomforts and inconveniences resulting from re- 
pression should be looked upon in the same light. 
After external tenotomies, double vision will 
sometimes continue to exist for several months, in 
looking to the extreme right or left, a condition 
that need not annoy the patient at all. This sel- 
dom follows tenotomy of the internal muscle. 
With care in developing fully, and continuance 
of the repression under prisms for several weeks, 
complete tenotomy can be performed in the ma- 
jority of cases without the occurrence of double 
vision. If the development has been high and 
double vision does occur, it soon corrects itself 
by the normal shortening of the cut muscle. 

Never should an operation be performed until 
the physician is absolutely certain that he has 
ascertained which muscle is short. An oversight 
of this kind might occasion very serious conse- 
quences to the patient. 

From the above conditions we can see that the 
results will be but temporary in an effort merely 
to balance the optic axes where there has been a 
manifest deviation. If we balance them for the 
time being, the process of shortening the already 
short muscle will in time tend to reproduce devia- 
tion in the same direction, and it will keep on 
doing so from time to time, necessitating many 
operations; indeed I have known as many 



1 86 THE EYE IN ITS 

as twenty. Life is too short for such a 
procedure, when by repression we can more rapidly 
discover the latent defects. In applying the 
maximum of prism under repression, and turning 
the eye toward the short muscle, we enable it to 
assume some normal action. It also begins to 
shorten. Before operating it is best to wait, if 
time is at our disposal, until the muscles have 
correlated themselves to this new position. Then 
a tenotomy has less tendency to turn the eye in 
the opposite direction and create diplopia. The 
ultimate outcome of immediate tenotomy that 
creates double vision, and of tenotomy after a 
new correlation has been established, will be the 
same; but in the latter case the inconvenience to 
the patient would be less immediately after the 
operation. In the case of the lateral muscles, 
complete tenotomy is not advisable if repression 
development has not reached I 5 deg. or upwards, 
and in the case of the vertical muscles it should 
have reached 12 deg. or more. In any deviation 
of the axes amounting to less than the above, my 
advancement operation with a ligature plate will 
bring about the small change of position needed 
with much more precision than tenotomy. Even 
in higher amounts of deviation, advancement with 
the ligature plate will fulfill the normal conditions 
in some cases more perfectly than tenotomy, 



RELATION TO HEALTH. 187 

especially in eyes that are large, prominent, and 
apparently very loose in their capsules. 

In developing a short muscle by repression, it 
is safe to conclude that, if we force it to its 
highest point for several months, we shall not be 
able to develop the muscle even then to as short 
or as near a normal condition as it would have been 
in had it not been stretched for thirty years or 
more. Just how much the short muscle has been 
lengthened and the long muscle shortened, during 
this long period of stretching, it is not possible 
to determine at once; but it is absolutely safe to 
conclude that in keeping the eye turned toward 
the short muscle as far as we can for a few months, 
we shall not stretch the long muscle as much as 
the short one has been stretched. 

When guided by symptoms and certain that 
we are right, we need have no fear of going too 
far with our repression, if it be continued for 
many months. Where from the time of birth the 
short muscle has been constantly stretched for 
thirty years, it will probably never be possible in 
the lifetime of the patient to make the muscle as 
perfect by repression as it would have been had 
it not been too short at the beginning. In the 
course of a few weeks, I have often discovered 
more than 50 deg. of latent defect, where none, 
or at most 2 deg. or 3 deg. was at first manifest 



1 88 THE EYE IN ITS 

by all diffusion tests. The method of merely 
balancing such manifest defects with prisms and 
operations can afford only temporary relief, and a 
small amount even of that. In a short time after 
all such corrections, a little more of the latent 
defect manifests itself, requiring still further cor- 
rection, and it continues to develop itself after 
each correction again and again through a long 
period of time; on the other hand, repression 
enables us to arrive at the desired end as quickly 
as possible, and perhaps lengthen, by many years, 
a life that would not have lasted through the 
slower process. In those cases where the most 
marked relief has followed tenotomies that 
brought about an immediate balance, I conceive 
that the eye has moved several degrees farther 
than the manifest deviation, but still just within 
the broad limit of the verticalizing and horizontaliz- 
insr function exerted under diffusion tests. 



RELATION TO HEALTH. 



XIV. 

THIS work is entirely confined to latent eye 
defects and the repression of abnormal nerve- 
impulse, and in no way is it intended as a text 
book on refraction or ocular surgery. Only one 
operation is set forth, because it is new. I think 
it offers many advantages over all others for the 
advancement of the recti. In all advancement 
operations the tying of the ligature is a question 
of judgment, and at the best we can only approxi- 
mate the required change of position. By such 
operations we can never hope to obtain anything 
like absolute accuracy in the change of the 
position of the eye, for the small difference of 
one millimetre may mean several degrees of 
deviation of the optic axes in one direction or the 
other. By my operation with the ligature plate, 
the desired position of the eye will be attained 
with much greater accuracy. 

The ligature plates are made of aluminum. 
They are about three millimetres in width, vary 
in length from about four millimetres to twelve 
or more, and weigh from one-eighth to three- 
fourths of a grain. They are spherically curved 
so as to fit the contour of the eye, their curva- 



190 THE EYE IN ITS 

tures being in varying diameters to meet the 
requirements of different sizes of eyes. The 
plate is slightly notched at each end, with a 
groove running from each notch its entire length 
on the convex surface, into which the ligature falls 
and is out of the way of producing any irritation. 
An incision is made through the conjunctiva 
and capsule of tenon in the direction of the 
muscle, and extending along its middle line, 
beginning at its scleral attachment and extend- 
ing as far as may be necessary. The muscle 
should then be entirely freed from its capsular 
and ocular attachments. A Stevens' hook is 
then passed behind the muscle and traction made 
toward the cornea; another hook is now passed 
behind the muscle from its opposite side and 
traction made in the opposite direction at the 
same time. The point of the second hook should 
be forced outside of the capsule so as to expose 
the muscle to view; a small curved needle carry- 
ing one end of a ligature is made to enter one 
margin of the muscle as far back from its scleral 
attachment as is necessary, pass, as nearly as pos- 
sible, transversely through its fibres, and come out 
on its opposite margin. This engages many more 
fibres of the muscle than the passing of the liga- 
ture directly through it. It also offers a much 
greater support to the ligature, there being much 
less likelihood of its tearing away; in fact, it never 



RELATION TO HEALTH. 191 

has torn away in my experience. After the 
ligature has been so far placed, a portion of the 
muscle can be cut away if it is deemed advisable. 
Unless the amount of advancement be very con- 
siderable, more than six millimetres, or one-fourth 
of an inch, the operation will generally prove 
fully as satisfactory without cutting the muscle. 
Each end of the ligature on its respective side is 
passed from the under side through the margin 
of the muscle close to its scleral attachment. 
After the two ends of the ligature have been 
brought through these parts of the muscle, the 
hooks are taken out. Each end of the ligature on 
its respective side is now brought through the con- 
junctiva from its under side, at a point about three 
millimetres in the direction of the cornea, from 
the scleral attachment of the muscle and about 
eight or ten millimetres apart, which the width of 
the scleral attachment should determine. The 
exits through the conjunctiva should be from 
three to four millimetres wider apart than the 
width of the scleral attachment. The two ends 
of the ligature should now be carefully tied by 
a surgeon's knot, not drawing the ligature so 
tight as to draw or pucker up very much the con- 
junctiva that it engages. Not much drawing for- 
ward of the muscle should be attempted in the 
first tying of the ligature, it should be just 
tight enough to insure the taking up of all slack 



I9 3 THE EYE IN ITS 

in the ligature. Or, where the conjunctival 
exits of the ligature were about eight millimetres 
apart, the tightening should be sufficient to draw 
them within about four millimetres of each other. 
The knot should be very carefully and firmly tied. 
Two strabismus hooks may now be used or a 
ligature dilator made for the purpose, and the 
muscle may now be advanced by traction in 
opposite directions. By this process the operator 
can now see about what length of a ligature plate 
should be used ; accordingly he firmly seizes the 
plate with a pair of forceps made for the purpose, 
and makes one of its notched ends to engage one 
side of the ligature. A somewhat strong Stevens' 
strabismus hook is now used to make traction on 
the opposite side of the ligature, and to slip it 
over into the notch on the other end of the liga- 
ture plate. The forceps and hook are now 
removed and the ligature and knot fall into the 
groove on the ligature plate, so that there is no 
possibility of its coming in contact with the con- 
junctiva and giving rise to even that amount of 
irritation that an ordinary ligature does. 

An examination can now be made to ascertain 
the exact position of the eye and the amount of 
advancement that has been accomplished. If it 
is not sufficient, a ligature plate of greater length 
can be made to replace the first. If too much 
advancement has been made, a shorter ligature 



RELATION TO HEALTH. J 93 

plate can be used. The ligature plate of a proper 
shape and carefully made never gives rise to the 
slightest irritation ; its presence is not even felt 
by the wearer. It should be left in for three or 
four days. 

When the operation is made without cutting 
the tendon, the muscle is tucked or folded upon 
itself, and the inflammatory action that follows 
fastens it in this position. The slight bunching 
or enlargement that results from the folding 
soon entirely disappears by absorption. After 
that stage of the operation where the ligature has 
been passed through the muscle the first time, a 
portion of the muscle can be cut away if it is 
deemed advisable. Unless the amount of ad- 
vancement is very considerable, the operation 
will generally prove fully as satisfactory without 
cutting the muscle. By this operation I have 
changed the position of the eye 30 deg. without 
cutting the muscle. 

Modifications of the above operation can be 
advantageously made in which this plate is still 
very useful. Where the conjunctiva is sufficiently 
strong to withstand the necessary traction, that 
stage of the operation where the ligatures are 
passed through the muscle at its scleral attach- 
ment, may be left out, so that, after the ligature 
has been passed through the muscle far enough 
back, the two ends may be brought out through the 



194 THE EYE IN ITS 

conjunctiva on their respective sides, eight or ten 
millimetres apart, as close to the cornea as possi- 
ble. If the conjunctiva is sufficiently strong to 
stand the dragging, the ligature plate prevents it 
from puckering up, and offers the advantage of 
increasing or lessening the effects of our opera- 
tion, at the same time hiding the ligature from 
any touch with the palpebral conjunctiva. In all 
the old operations, after the ligature has been 
tied, if the position of the eye is not satisfactory, 
any alteration involves a new ligature and another 
operation ; whereas with the ligature plate these 
alterations can be made by substituting plates of 
different lengths. 



RELATION TO HEALTH. 195 



XV. 



IN refutation of the possible claim that the 
results in the foregoing clinics are due to 
"suggestion," I deem it advisable before conclud- 
ing this work to say something on the subject of 
hypnotism, although it is a digression from the 
subject under consideration. I do not propose to 
enter any denial as to the remarkable phenomena 
that are exhibited in various hypnotized subjects. 
These are established and undeniable facts. The 
entire investigation of the subject of hypnotism 
has been confined to a study of its effects on 
the hypnotic subject. Prevailing through all of 
this has been the general superstitious idea that 
some mysterious force passed from the operator 
to the person operated upon, or from the stronger 
to the weaker mind; while there has been little or 
no effort in the direction of determining what the 
actual physical causes were that brought about 
these results. The easiest subject for hypnotism 
is the neurasthenic, whose general supply of vital 
force for various functions is very limited. Like 
a dynamo, the nerve-centers are capable of gen- 
erating a given amount of vital force. In persons 
suffering from nervous debility, the supply of 



196 THE EYE IN ITS 

nerve-force is restricted and is not sufficient to 
carry on with vigor the various functions through- 
out the animal economy. We must remember 
that thought or ideation, of whatever nature it 
may be, is a process that requires nerve-impulse 
for its performance ; also, that a pain consists of 
an abnormal nerve impulse. 

"Suggestion" that gives rise to the so-called 
hypnotic, psychologic or mesmeric condition may 
act through the medium of any one or more of 
the five senses. 

If a person in possession of a valuable treasure 
were to enter at night an isolated house which he 
had every reason to believe was unoccupied by 
any other person, and while slowly feeling his 
way in the dark, from room to room, should sud- 
denly feel a hand placed on his shoulder, a radi- 
cal change would at once take place in his 
nerve-centers, and such a change would be 
greater or less according to his condition and 
surroundings. 

If a person who was familiar with the taste of 
various poisons were to enter a dimly lighted 
apothecary shop and carelessly swallow a dose of 
something supposed to be a sweet cough mixture, 
and the dose suddenly proved to be intensely 
bitter, he might at the time think he had taken a 
dose of strychnine, and a change in the action of 
the nerve-centers would take place, commensurate 



RELATION TO HEALTH. 197 

with the condition of the person and his sur- 
roundings. I have known such an accident to 
produce complete prostration ; but when it was 
learned that the bitter dose was quinine, the re- 
covery was rapid. 

The smell of smoke in a high building with 
insufficient means of egress might suggest the 
idea of a horrible death by fire, and varying con- 
ditions would result in the nervous systems of the 
persons so frightened. 

Through the medium of the sense of hearing 
very potent changes in the nervous system are 
brought about. One Sabbath morning many 
years ago I was sitting on the veranda of a hotel 
in the South, when suddenly I heard a most ter- 
rific and unnatural sound, the building trembled 
violently, the air seemed dense and oppressive. 
For the moment I was helpless, I could not think, 
I could not move ; the horrible, weird strangeness 
of the sound had suspended my functions of 
volition and reason. The time was but a 
moment, but it seemed many to me ; then I saw 
falling by me to the ground the mutilated form 
of a man. This recalled me somewhat to my 
senses. There had been an explosion. 

Remarkable changes are aroused in the nerve- 
centers through the medium of vision ; intense 
feelings of pleasure, pain or fear are induced by 



I9 S THE EYE IN ITS 

"suggestion" through this medium. The lover 
of nature is hypnotized as he looks upon some 
strangely grand or beautiful scene ; "suggestion" 
from the inanimate surroundings has influenced 
the action of his nerve-centers. 

Complete prostration and often unconscious- 
ness are induced by something that is seen. The 
changes that are wrought in the nervous system 
by the strange and fantastic "passes" or "move- 
ments" that are made by the so-called mesmerist, 
hypnotist or psychologist are no more due to a 
force or entity that passes from the operator to 
the subject, or from the stronger to the weaker 
mind, than the similar mental conditions men- 
tioned above are due to the transference of a 
similar entitv or force. Inasmuch as similar 
effects are brought about by inanimate surround- 
ings, it is evident that there need be no transmis- 
sion of a force to produce the hypnotic state. 
The interesting and amusing phenomena that are 
brought about by "suggestion" are commensurate 
with the weakness or excitability of the nervous 
system of the subject. 

After the "suggestion" all the changes or 
phenomena that take place in the subject are due 
to the action of forces in his nerve-centers. A 
belief that there is some mysterious force sent 
out by the operator or the stronger mind is very 



RELATION TO HEALTH. 199 

foolish and dangerous, for persons so believing 
are easy subjects, and become victims of persons 
of evil design. 

When the imagination is sufficiently excited 
by "suggestion" there is so excessive a call upon 
the nerve-centers for vital force to sustain the 
exalted ideation, that all other functions for the 
time being are robbed of the limited vital impulse 
with which they were previously supplied. The 
nerve-impulses that gave rise to the functions of 
feeling, motion and reason are perverted ; and 
where pain existed the abnormal impulse that 
gave rise to it has been turned aside and utilized 
in the strong imagination that has been awakened. 
The subject is utilizing all his feeble vital forces 
to maintain an excited mental condition that has 
been aroused by "suggestion," which may be by 
the word of mouth, motion, general surroundings 
or exciting events. Where pain is relieved by 
hypnotism, it is because the impulse that gave 
rise to it has been perverted into this new channel. 
Where the function of feeling is' suspended, it is 
because the vital forces have been so drawn upon 
that there is not sufficient left to give rise to the 
function of feeling. Where the reasoning fac- 
ulties are so perverted that one can be made to 
believe and apparently see things as they are not, 
it is because the excitation has so utilized the 
vital forces that there is not sufficient left to 



200 THE EYE IN ITS 

assert reason, and whatever is suggested is ac- 
cepted as truth. Hypnotism or "suggestion" is 
the diversion into other channels of those nerve- 
impulses that give rise to feeling, motion or 
reason, the turning of them aside from the per- 
formance of normal functions to execute another 
kind of work. 

It is on this principle that a mustard plaster 
or any other counter irritant acts : it turns aside 
the nerve-impulses that gave rise to pain and 
utilizes them in the secondary or induced irri- 
tation. 

" Some ideas are suggested to the mind by all 
the ways of sensation and reflection." — (Locke.) 

" Suggest : To introduce indirectly to the 
thoughts ; to cause to be thought of, usually by 
the agency of other objects." — (Webster.) 

When a person steps upon a tack it suggests 
thoughts and sometimes words that are very em- 
phatic ; the savory smell of a broiling mutton 
chop will often suggest hunger ; the whistle of 
a locomotive suggests that more haste will have 
to be made or the train may be missed ; whenever 
I hear a certain piece of music it always suggests 
to me the lovely Jepsom Gardens and the Holly 
Walk at Leamington on the river Learn, for it 
was there that I first heard this music ; the taste 
of some delicious viand often suggests some other 
time and scene where this flavor awakened a 



RELATION TO HEALTH. 201 

more than ordinary degree of pleasure ; seeing 
another put on his gloves and hat might suggest 
to a man that it was time to go home. " Sug- 
gestion" in its fullest sense is susceptible of a 
very broad definition. 

" Hypnotism," a word of Greek derivation, 
and meaning sleep, is at present used in almost 
as broad a sense as the word "suggestion," and 
many of the mental states that result from "sug- 
gestion " are denominated "hypnotic." The 
average mind is quite as open to "suggestion" in 
the present day as it has been in all ages past. 
It is not capable of reasoning for itself. It gen- 
erally follows out certain lines of action because 
they are conventional or have been "suggested" 
by others. A collegiate training is valuable to 
those minds that are capable of receiving it, for 
it imbues them with formulated methods of 
analysis and action, which methods are the pro- 
ducts of reasoning minds that have thought for 
the benefit of others. What is called original 
thought comes to but few. "The power of step- 
ping out of the beaten track of thought, of 
bursting by a happy inspiration through the 
bonds of habit and originating a new line of re- 
flections, is most rare, and should be welcomed 
in spite of its sometimes becoming extravagant." 

At present the people in several sections of 
our great republic are running wild over the 



202 THE EYE IN ITS 

question of hypnotism. Many of these unthink- 
ing minds have been led to believe that when- 
ever a buffoon raises his hands and makes 
certain meaningless motions, they are bound to 
become helpless and follow whatever suggestions 
he may make. Excessive fear and awe are the 
results of this belief, and an exalted excitation of 
the nerve-centers results, which may actually pro- 
duce what is called the "hypnotic" state; but 
where this belief does not exist, and where there 
is an unbelief as to this mysterious force, however 
weak the subject may be, these methods fail to 
hypnotize. 

I remember a mesmerist who several years ago 
was lecturing in a small town in Ohio. He had 
succeeded in exciting quite a large number of the 
community. The audiences of his nightly lectures 
grew until the opera house would barely hold 
them. Fie was very much reassured by his success 
and invited the opinion of any member of his 
audience. A professional gentleman walked to 
the rostrum and set forth, in a very clear and con- 
cise manner, opinions similar to those given in 
this chapter. From that time his so-called hyp- 
notic power ceased, and of the ten subjects on the 
stage who had been obeying his suggestions, there 
were but two who continued to do so. These 
were strangers to the community, and I afterwards 
learned from one of them that they were both 



RELATION TO HEALTH. 203 

under his pay at a salary of #15 per week. It is 
not necessary for a hypnotist to resort to this 
trickery, for if a firm belief in the mysterious force 
exists in a person with a weak nervous system, he 
can undoubtedly be hypnotized. It is now high 
time for thinking professional men to come to the 
assistance of the unthinking masses, and teach 
them that it is as unnecessary to yield up reason 
and thought to the gyration of the hypnotist's 
arms as to the whirling of a merry-go-round. 

Horses are almost universally hypnotized when 
a barn takes fire. Invariably they refuse to leave 
their stable. It has always been their place for 
feed, drink and rest. In their thoughts it is most 
safe and comfortable of all. Under the exalted 
excitement of the nerve-centers of the animal, all 
other instincts vanish. 

I have a number of chickens which were 
hatched last spring and had never seen the snow 
until this winter. On a Friday evening one 
perched itself on an elevated portion of the hen 
house. During the night a heavy snow fell. On 
the following Tuesday evening my neighbor came 
in to tell me that there was a hen standing on top 
of my hen house and that it had been standing 
there for four days. At least, every time any- 
body looked out of the window, the hen was seen 
standing in the same position, and it was inferred 
that she must have been standing there all that 



204 THE EYE IN ITS 

time. I became interested, at once went into the 
back yard, crawled on to the roof, and approached 
the hen. She paid not the slightest attention to 
my presence ; she seemed perfectly unconscious 
of all surroundings. As I stretched my hands 
toward her, she did not move, but after I seized 
her, she at once began to squawk. 

In looking from a high tower or precipice some 
people experience a feeling allied to hypnotism. 
Wonder, awe and fear so utilize the vital forces 
that reasoning and self-control are temporarily 
gone. The many so-called suicides committed 
by jumping into Niagara Falls or from high towers, 
are acts committed in the hypnotic state ; at least, 
I believe a great mistake is made in indiscrimi- 
nately calling such acts suicide. It is a notable 
fact that all high towers have to be protected 
so that people cannot jump from them. The 
Washington Tower, the London Monument, the 
Eiffel Tower, the dome at the Capitol of Wash- 
ington and many others have had wire network or 
other apparatus put up to prevent persons from 
jumping from them. I think it is a grave injus- 
tice to call all such acts suicide. 

It is perhaps a mistake to allow the word hyp- 
notism to assume as broad an application as is now 
popular. In this sense every speaker, every 
preacher is a hypnotist. Each suggests his good 
thoughts from the pulpit or the rostrum and 



RELATION TO HEALTH. 205 

endeavors thereby to influence his hearers. The 
successful jurist by rhetoric, oratory, earnestness 
and gestures, hypnotizes the jurymen until tears 
mark the result. Every business man, every 
solicitor utilizes, to his utmost, his power of sug- 
gestion, for the sake of influencing his customers. 
What I wish particularly to point out in this 
chapter is that there need be no transference of a 
mysterious force from the operator to the subject 
to bring on hypnotic states, inasmuch as inanimate 
surroundings can produce a similar effect. 

Considered in the line of the above hypothesis, 
the changes that take place in so-called "faith 
cures" are easily accounted for. It is probably a 
fact that many deranged functions have been 
restored to more normal action through an effect 
on the nerve-centers brought about by " sugges- 
tion " in the form of Christian Science, hypnotism, 
or faith cure. We are fully aware that fright is 
often the exciting cause of deranging the nerve- 
centers to the extent of disturbing some important 
function. Fright has also been known to restore 
to normal action a disturbed function. In 
aphonia, which is of frequent occurrence in cer- 
tain individuals suffering from nervous debility, 
the power of speech has often been restored by 
some person approaching the patient unobserved, 
suddenly making a loud sound close to the ear, 
and so causing fright. 



206 THE EYE IN ITS 

This switching or transference of nerve- 
impulse may possess some value in scientific 
hands, but in no way does it fulfill the require- 
ments of enfeebled or insufficient nerve-centers. 
The true end to be sought is vigor and equilib- 
rium of action in all the nerve-centers, so that all 
functions may receive a normal share of nerve- 
impulse for their performance; a result which is 
hardly to be expected from suggestion or faith 
alone. A fair average of success in this direction 
is illustrated in Walter Scott's "Waverley," where 
the Scotchman tried to teach his mule to do 
without food. He gradually reduced the poor 
animal's feed until he ate but one straw a dav, 
when he died. 

Again I repeat, hypnotism or " suggestion " is 
the diversion into other channels of those impulses 
that give rise to feeling, motion and reason; it is 
the turning of them aside from the performance 
of their normal functions to execute another kind 
of work. 

That the favorable results brought about by 
repression are not due to " suggestion " is evident 
from the following illustration. A person requir- 
ing a prism in a certain position for repression is 
materially relieved while the prism is in the 
proper position. If, without the knowledge of the 
patient, the prism be reversed, all the unfavorable 
symptoms will be materially aggravated, while 



RELATION TO HEALTH. 207 

the " suggestion " to the patient is the same with 
the prism in one position as the other. Such 
tests can be repeatedly made on patients under 
repression, and the results are uniformly the same. 
The proper position of the prism always relieves, 
and the reverse always aggravates the symptoms; 
consequently "suggestion" is not the source of 
the relief. Adverse " suggestion " and ridicule from 
those unfamiliar with the philosophy of this sub- 
ject have exerted their fullest influence in dis- 
couraging patients and counteracting the favorable 
results. I believe and do not hesitate to say that 
many people have sacrificed their lives through 
following the advice of persons who were ignorant 
of the science of the subject. It is always unwise 
to give advice without first possessing the neces- 
sary information. We should never accept and 
act upon advice until we have settled in our mind 
the qualifications of the person giving it. Has 
he grounds for his claim to a superior knowledge 
of the matters on which he advises? 

When the philosophy set forth in this work is 
more generally understood, it is certain to be 
generally practiced, and its benefits will be shared 
by many sufferers. For his years of labor, the 
author deems himself well rewarded by the results 
already obtained, although he looks upon these 
results only as the earnest of greater things to 
come. 



GLOSSARY. 



Abnormal Innervation: An excess or insufficient supply 
of nerve-impulse. 

Afferent Nerve -impulse : An impulse conveyed from 
without to the nerve-centers. 

Brain - leak : A waste of nerve-force. 

Degree : An angle equivalent to g4 7 part of a circle. 
The prism degree mentioned in this book is equivalent 
to about a half degree in trigonometry. 

Differential Test: A test for determining the ability 
of the eyes to fuse in opposition to prisms in different 
positions. For instance, base down before one eye and 
then the other, or up before one eye and then the other, 
noting the difference in the prism-power that can be 
fused for in these varying positions. 

Diffusion Tests : Tests that create double vision, either 
by the use of means calculated to lessen the natural 
stimuli of the eyes or by the use of prisms. 

Dynamic Centers : Centers in the nervous system where 
nerve-force is generated and sent forth for the perform- 
ance of functions. 

Efferent Nerve - impulse : An impulse that is con- 
veyed from the nerve-centers outward. 

Fogging : Dimming the vision and stimulating the ciliary 
muscle to relax its tonic spasm, by the application to 
the eye of a convex glass. 

Heterophoria : Different tending of the optic axes or 
lines of sight. 

Esophoria : Inward tending of the lines of sight. 

Exophoria : Outward tending of the lines of sight. 

Hyperphoria : Upward tending of the lines of sight. 

t : Downward tending of the lines of sight. 
Hypophoria ) & 

209 



210 GLOSSARY. 

HORIZONTALIZE : To fix the eyes so that the lines of sight 
will fall in a horizontal plane. 

Innervation: The act of furnishing nerve-force. 

Latent Eye - strain : Eye-muscle defects that are hidden 
and not discoverable by diffusion tests. 

Manifest Eye -strain: Eye-muscle defects which are 
at once discovered by diffusion tests. 

Metastasis : The change of a disease from one part of 
the body to another. 

Motive -force : Nerve-impulse or nerve-force, which is 
the dynamic force in the performance of function. 

Mydriatic : A drug that dilates the pupil and relaxes 
the ciliary muscle of the eye. 

Neurasthenia : An insufficient supply of nerve-force. 

Neurosthenia : An irritant or excessive supply of nerve- 
force. 

Orthophoria : Regular or correct tending of the optic 
axes or lines of sight. 

Paranoia : Insanity in which the acts are systematized. 

Polarity : The quality by which a body exhibits the 
power to attract and repel. 

Repression : The abatement of an excessive nerve- 
impulse, accomplished by reversing a strain. 

Reverse Manifest Eye -strain: A strain that turns 
an eye in the direction opposite to the muscle that is too 
short. 

Traumatic : Pertaining to injuries or wounds. 

Verticalize : To fix the eyes so that the lines of sight 
will fall in a vertical plane. 

Zymotic : Pertaining to the deleterious effects of mi- 
crobes, as in producing disease. 



INDEX. 



Abnormal innervation, 26-27; causes 
diseases of the eye, 43. 

Accommodation, broken down, 142. 

Accommodation, 153. 

Action of medicines, 56. 

Advancement of the ocular mus- 
cles a new operation, 189. 

Advance medical science, 8. 

Alcoholism, cure for, 49-53. 

Alterations of function are all pri- 
marily central in the nervous sys- 
tem, 19. 

Anatomical location of nerve-cen- 
ters, 20-21, 35. 

Apparent defects, 177-178. 

Art gallery and sight seeing ex- 
cites the nerve-centers, 24. 

Assimilation, 19-20. 

Asthma, 48. 

Astigmatism, 151-1S2. 

Atom of the body, every, has some 
office, 17-19. 

Atrophy of the optic nerves and 
general debility. Case XVI, 113. 

Before operating, 182. 

Belief in long established theories 

quite natural, 16. 
Blood simply a carrier, 20. 
Bronchitis, chronic. Case XIV, 

109. 

Cataphoria and hyperphoria, 178. 

Cataract, 43. 

Catarrh, 48, 59. 

Cathartic a, acts on the nerve 
centers, 61-62. 

Caution in testing, 135-136. 

Ciliary muscle, 137. 

Constipation a nerve-center de- 
rangement, ( 1. 



Consumption, 64. Case X, 104; 

case XI, 105; case XII, 107; case 

XIV, iio-iii. 
Correction of manifest defects 

gives only temporary relief, 185- 

188. 
Correlation, 153-154. 
Critic, a, 7. 

Danger lies in the eyes remaining 
in that abnormally balanced con- 
dition that is threatening life. 
Case IV, 95. 

Deafness, ovaritis and general de- 
bility. Case XX, 125. 

Defect in one muscle sometimes 
hides defects in others, 99. 

Diabetes, 47. Case V, 95; case 
VII. 98; case XVII. 114. 

Development of the ocular mus- 
cles, 174-176. 

Differential test, 156-158. 

Diffusion tests, 167-170. 

Disease, causes of, 5, 66-67; im- 
munity from, 44-46; we do not 
inherit disease, 64; diseases of 
the eye due to abnormal inner- 
vation, 43; disease is localized 
nervous derangement, 46; dis- 
ease and health, 40. 

Distances, judgment of, 153-154. 

Double vision after tenotomies, 
185. 

Effect, every, has a cause, 23, 61. 

Endurance of various nerve-cen- 
ters, 33-34- 

Epilepsy. Case VIII, 99. 

Esophoria, 174-177. 

Excitement emphasizes functions, 
18. 



INDEX. 



Experience in old methods of no 
value in formulating opinions of 
new methods, 8. 

Exophoria, 177. 

Eye muscles, 68; complex arrange- 
ment of, 69; physiology of the, 
171, 173; why defects in the eye 
muscles are so deeply hidden, 
75-76; defects in the eye muscles 
locked together, 154-155. 

Eye-strain, evidence of the univer- 
sality of, 70-76, 130. 

Eye- train, latent, often causes 
nervous derangement, 43; repres- 
sive, 132. 

Eye-strain, manifest, causes little 
disturbance, 133-134. 

Eyes of new-born infants, 71. 

Eyes of the dead, 72. 

Eyes of the dipsomaniac after 
death, 73-74. 

Eyes that perform perfect vision 
may have serious defects, 70. 

Feeling is all in the nerve-cent- 
ers, 55. 

Five senses, the, are feelings, 33. 

Fogging, 141-142, also 155-164; some- 
times induces sleep, 142-143. 

Function, every, is performed by 
nerve or motive impulse, 17. 

Function, normal or abnormal, is 
characterized by the nature of 
the nerve-impulse, 21-23, 4S; func- 
tions are emphasized under ex- 
citement, 18. 

Functional disturbances, contin- 
ued, result in organic disease, 55. 

Function, character of, depends 
on the character of nerve force 
supply, 21-22. 

Fusion, 35-3Q; 135. 

Glaucoma, 43. 

Growth and formation of all parts 
of the body are influenced by a 
person's surroundings, 2S-34. 

Growth of tumors, 41, 55. 

Gymnastic exercises of the ocular 
muscles, 131. 



Hay fever, 48. 

Health and disease, 40. 

Health may continue to improve 
for years, 78. 

Health must be carefully guarded 
when restored, 78. 

Homoeopathic principle, 56. 

Horizontalizing tendency and ver- 
ticalizing tendency, 35-39. 

Hypermetrophia, manifest and 
latent, 137-139; functional mani- 
fest, 138; non-functional mani- 
fest, 138. 

Hyperphoria and cataphoria, 178. 

Hypnotic phenomena, the force 
that produces the. 195, 207. 

Immunity from disease, 44-46. 
Imperfect structure co-existent 

with perfect vision, 9-14. 
Inflammation, 53- 
Insanity. Case XIX, 116. 
Intent of this work, 42. 

Judgment of distance, 153-154. 
Just estimate can be arrived at 
only by perusing all the pages, 8. 

Latent muscular defect. Case 

III, 87. 
Laws of refraction in an advanced 

state, 9. 
Lesion, a, is always a result and 

not a cause, 41, 60. 

Medicines, action of, 56. 

Mental suggestion 14-15, 195, 207. 

Metastasis, 53-54. 

Microbe theory, 44-46. 

Motor ataxy, 65. Case VI, 96. 

Muscular defects, how they mani- 
fest themselves. Case I, 79; 
partly manifest, case II, 81; 
latent, case III, 87; manifest 
muscle defects more common in 
the lateral muscles, 167, 178; 
muscle defects may be entirely 
latent to diffusion tests, 42. 

Muscular weakness, 129. 



INDEX. 



Mydriatics — hyoscyamine, atro- 
pine and their congeners, 139. 

Myopia takes its origin as hyper- 
metropia, 143-151; its probable 
cause and how to guard against 
it, 149-151. 

Names of diseases, 46-48. 

Negligence, evidence of, 102. 

Nerve-center, each, is intimately 
connected with all other nerve- 
centers, 27. 

Nerve-centers, 20-21; anatomical 
location of, 35; what part of the 
nerve-centers has the greatest in- 
fluence, 28-29. 

Nerve-centers compared with the 
electric dynamo, 25. 

Nerve-impulses, afferent and ef- 
ferent, 58, 63-64; the prime mover 
in all functions, 42; obstinacy of 
established nerve-impulse, 78. 

Nerves supplying the ocular mus- 
cles, 171. 

Nerve transplantation, 63. 

Nerves are passive and without 
feeling, 48-49. 

Nervous derangement often the 
result of eye-strain that is en- 
tirely latent, 43. 

Neurosthenia and neurasthenia, 
26. 

New correlation, 76, 78. 

New methods produce new re- 
sults, 7. 

Number of degrees of deviation in 
the optic axes can never deter- 
mine the amount of eye-strain, 
133. 

Obstinacy of established nerve- 
impulse, 78. 

Ocular muscles, relative strength 
of, 129; advancement of, a new 
operation, 1S9; gymnastic exer- 
cise of the, 131. 

Offer of clinical demonstrations, 
S- 9 . 

Optic axes, 35-39; why they deviate, 
129. 



Organic disease the result of con- 
tinued functional disturbance, 55. 

Organic products depend on the 
nature of the nerve-impulses, 63. 

Orthophoria, relative and individ- 
ual, 165. 

Ovaritis, 54, 60-61. 

Ovaritis and diabetes. Case III, 
87; case IV, 91. 

Over-develop, can we, a muscular 
defect, 180. 

Paralysis and complete loss of 

mind. Case XVIII, 115. 
Paralysis, cure of. Case IX, 102. 
Paresis, 129. 
Part of the body, every, is like an 

engine, 17-18. 
Perfect brain, a, its tendency is to a 

perfect body and a perfect life, 73. 
Perfect pair of eyes, not one in a 

hundred, 69-70. 
Perfect vision under serious eye 

defects, 178-179. 
Positions of the head, 1S1. 
Power of the eye to hide defects, 

74-75- 
Physiology of the eye muscles, 171, 

173- 

Reflex and reflex diseases, 58-59. 
Relief of pain is no evidence of 

cure, 76-77. 
Repressing abnormal innervation 

differs from the correction of 

muscular insufficiency, 13. 
Repression, 145, 15S-164. 
Repressive eye-strain, 132. 
Reverse manifestation, 12. Case 

IV, 91. 

Secondary reflexes, 65. 
Shaking palsy. Case XV., 112. 
Shortening of the stretched muscle 

after operation, 184. 
Sight awakens a feeling of all the 

other senses, 30-31; is an active 

function requiring vital energy 

or nerve-force, 24-25. 
Sight, taste, smell and hearing, 

29-31. 



214 



INDEX. 



Stretched muscles are undevel- 
oped, 153, 183-184. 

Suggestive mental poison, 207, 

Symptom tests, 161-162. 

Systemic depressants and stimu- 
lants, their influence, 139. 

Tabulated clinics, 126-128. 
Tendency of a perfect brain is to a 
perfect body and a perfect life, 73. 
Too much light is injurious, 31-32. 
Transplantation of nerves, 63. 
Tumors, growth of, 41, 55. 



Verticalizing tendency and hori- 
zontalizing tendency, 35-39. 

Visual centers, 35-37; they are the 
most sensitive, 34. 

We do not inherit disease, 64. 
What part of the nerve-centers 

has the greatest influence, 28-29. 
Why defects in the eye-muscles 

are so deeply hidden, 75-76, 80; 

locked together, 154-155. 
Why man and wife grow to look 

alike, 2S. 



